The influence of age and health status for outcomes after mid-urethral sling surgery-a nationwide register study.
Int Urogynecol J
; 34(4): 939-947, 2023 04.
Article
en En
| MEDLINE
| ID: mdl-36181548
ABSTRACT
INTRODUCTION AND HYPOTHESIS:
The efficacy of mid-urethral sling (MUS) surgery in older women and women with a significant disease burden is limited. We aimed to determine the influence of chronological age and physical status (assessed by the American Society of Anesthesiologists Physical Status, ASA) classification on outcomes.METHODS:
Cure rate, change in frequency of lower urinary tract symptoms, satisfaction, impact, and adverse events after MUS surgery were assessed in 5200 women aged 55-94 years with MUS surgery (2010-2017). Data were analysed by multivariate logistic regression and Mantel-Haenszel chi-square statistics.RESULTS:
The cure rate was 64.2% (95% CI, 60.0-68.4) in the ≥ 75-year cohort compared to 88.5% (95% CI, 87.1-89.8) in the 55-64-year cohort (trend p < 0.0001). The estimated probability of cure, improvement, and satisfaction with the procedure decreased by aOR10yr = 0.51 for cure to aOR10yr = 0.59 for satisfaction (all p < 0.0001). Women with a significant health burden (ASA class 3-4) had lower cure rates and satisfaction than those without (65.5% vs. 83.7%, p < 0.0001 and 65.7% vs. 80.6%, p < 0.0001). Older age was more likely to be associated with de novo urgency (p = 0.0022) and nocturia ≥ 2 (p < 0.0001). Adverse events, readmission, and 30-day mortality rates were low. Women, irrespective of age, were equally satisfied if they experienced a decrease of at least one step in leakage frequency.CONCLUSIONS:
Even if MUS surgery in older women and those with ASA class 3-4 was associated with a lower cure rate and less satisfactory outcome, a majority were satisfied provided they experienced a reduction of incontinence episodes.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Incontinencia Urinaria
/
Incontinencia Urinaria de Esfuerzo
/
Cabestrillo Suburetral
Límite:
Aged
/
Female
/
Humans
Idioma:
En
Revista:
Int Urogynecol J
Asunto de la revista:
GINECOLOGIA
/
UROLOGIA
Año:
2023
Tipo del documento:
Article
País de afiliación:
Suecia