Does specialty affect sling complication rate?
Munich, Germany—Gynecologists derive higher complication rates than urologists during the first 30 days following sling procedures for urinary incontinence, according to a multicenter study presented at the European Association of Urology annual congress in Munich, Germany.
Commentary: Urologists, GYNs demonstrate slings' safety
However, the difference was small and most complications were slight—primarily post-procedure urinary tract infections.
The authors arrived at these findings by delving into data amassed by the American College of Surgeons National Surgical Quality Improvement Program (NSQIP). They reviewed 10,508 sling procedures for stress urinary incontinence conducted between 2006 and 2013.
Procedures performed by gynecologists (5,970) were associated with a higher rate of UTIs (3.6%) compared to the 2.3% rate seen in 4,538 procedures conducted by urologists (OR: 1.55, 95% CI: 1.23-1.97, p<.0001). Gynecologists also had a higher rate of overall complications than urologists: 4.1% vs. 2.9% (OR: 1.42, 95% CI: 1.15-1.76, p=.001).
“Large sample sizes can make small differences statistically significant. The question is whether they are clinically meaningful,” first author Björn Löppenberg, MD, a research fellow at Brigham and Women’s Hospital, Boston, told Urology Times.