title: Repeat surgery after failed midurethral slings: a nationwide cohort study, 1998-2007.
abstract: OBJECTIVE
  The objective was to describe the choice of subsequent surgery after failure of synthetic midurethral slings (MUS) based on a nationwide background population.
  
  
  METHODS
  We used the Danish National Patient Registry to identify women who had undergone first-time synthetic MUS from 1998 through 2007. The outcome was repeat surgery with any subsequent procedure code for urinary incontinence within a 5-year period of the first procedure.
  
  
  RESULTS
  A total of 5,820 women (mean age 55.4 years, ± 12.1) were registered with a synthetic MUS, and 354 (6 %) underwent reoperation. The first-choice treatment for reoperation was a synthetic MUS (45.5 %) followed by urethral injection therapy (36.7 %) and miscellaneous operations (13.8 %). Pubovaginal slings (2.8 %) and Burch colposuspension (1.1 %) were seldom used. At reoperation, 289 women (82 %) were treated at the department where they had undergone their primary synthetic MUS.
  
  
  CONCLUSIONS
  In this nationwide cohort study of synthetic MUS a repeat synthetic MUS was the first choice and urethral injection therapy a frequent second choice. The majority of reoperations (82 %) took place in the same department as the primary operation.
authors.affiliation: Center for Clinical Epidemiology, South, Odense University Hospital and Research Unit of Clinical Epidemiology, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark. mfoss@health.sdu.dk.
authors.forename: Margrethe Foss
authors.initials: MF
authors.lastname: Hansen
authors.affiliation: Herlev Hospital, Department of Obstetrics and Gynaecology, Herlev, and Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Gunnar
authors.initials: G
authors.lastname: Lose
authors.affiliation: Herlev Hospital, Department of Obstetrics and Gynaecology, Herlev, and Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Ulrik Schiøler
authors.initials: US
authors.lastname: Kesmodel
authors.affiliation: Center for Clinical Epidemiology, South, Odense University Hospital and Research Unit of Clinical Epidemiology, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
authors.forename: Kim Oren
authors.initials: KO
authors.lastname: Gradel
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003718:Denmark; D013509:Gynecologic Surgical Procedures / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D012086:Reoperation / Q000706:statistics & numerical data*; D053825:Suburethral Slings / Q000706:statistics & numerical data*; D017211:Treatment Failure; D014549:Urinary Incontinence / Q000628:therapy*
keywords: Midurethral slings; Reoperation; Repeat surgery; Tension-free vaginal tape; Transobturator tape