ArticleObstetrics and gynecology2019
Evaluation of the Effect of Surgeon's Operative Volume and Specialty on Likelihood of Revision After Mesh Midurethral Sling Placement.
Article in Obstetrics and gynecology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The impact of surgeon operative volume on risk of reoperation within 5 years of mid-urethral sling: a systematic review.International urogynecology journal · 2023Pooled it
- Minimally invasive sacroiliac joint fusion: Primary endpoint results from the prospective, multicenter STACI study.PM & R : the journal of injury, function, and rehabilitation · 2026Trial
- Babcock versus Scissor Tensioning for Retropubic Mid-Urethral Slings: Comparing Two Intra-Operative Techniques Through 5 Years of Follow-Up.International urogynecology journal · 2025Trial
- Two Intraoperative Techniques for Midurethral Sling Tensioning: A Randomized Controlled Trial.Obstetrics and gynecology · 2020Trial
- The Impact of Surgeon's Expirience and Volume on Pelvic Reconstructive Surgery Outcome.International urogynecology journal · 2026Review
- A time-frame comparison study of surgical volume shifts on female primary stress urinary incontinence surgery.International urogynecology journal · 2023Article
- Reoperation rates of stress incontinence surgery in rural vs urban hospitals.AJOG global reports · 2022Article
- Short term complications in mesh augmented vaginal repair of pelvic organ prolapse are not higher when compared with native tissue repair.International urogynecology journal · 2022Article
- Synthetic slings in the treatment of urinary incontinence: lessons learned and future perspectives.International braz j urol : official journal of the Brazilian Society of UrologyArticle
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo estimate rates of revision surgery after insertion of mesh midurethral slings and explore whether physician specialty, annual operative volume, or hospital type are associated with this outcome.
methodsA population-based retrospective cohort of women undergoing midurethral sling procedures over a 13-year interval (2004-2017) in Alberta, Canada was created using administrative health data. The primary outcome was subsequent surgery for revision of midurethral sling, defined by a composite of surgical procedures. Exposures included annual number of midurethral sling procedures performed by the surgeon, surgeon specialty, facility type, patient age, and concomitant prolapse repair. Mixed effects logistic regression using linear spines was used to test a-priori hypothesis that annual surgical volume would be inversely related in a nonlinear fashion to risk of revision.
resultsIn the cohort of 19,511 women, cumulative rates of revision surgery were 3.84% (95% CI 3.54-4.17) at 5 years and 5.26% (95% CI 4.82-5.74) at 10 years. The first year after midurethral sling placement was the most vulnerable window, with 0.40% (95% CI 0.31-0.49) undergoing revision within 30 days and 2.15% (95% CI 1.95-3.52) within 1 year. Concomitant prolapse repairs (odds ratio [OR] 1.24, 95% CI 1.04-1.48) and surgeon's annual volume were associated with revision. After 50 cases per year, odds of revision declined with each additional case (OR 0.99/case, 95% CI 0.98-0.99, OR 0.91/10 cases, 95% CI 0.84-0.98) and plateaued at 110 cases per year. Surgeon specialty, hospital type, and patient age were not associated with outcome.
conclusionOne in 20 women undergo revision surgery within 10 years after midurethral sling placement. Higher physician surgical volume is associated with decreased risk, with the decline occurring at a threshold of 50 cases annually. Minimum caseload parameters for surgeons performing midurethral sling procedures may improve quality of these procedures.
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