Table 2.
Obstetrical and constitutional risk factors for subjective failure 6–12 months after MUS for the study group (n = 14,787)
| Obstetric and constitutional variables | Subjective failure % (N)a | Crude OR (95% CI) | p | Adjusted OR (95% CI) | p |
|---|---|---|---|---|---|
| Parity | |||||
| 0 | 33.8 (183/541) | 1.27 (1.05–1.53) | 0.012 | 1.18 (0.94–1.47) | *0.148 |
| 1 | 29.9 (472/1579) | 1.06 (0.94–1.20) | 0.350 | 0.95 (0.81–1.12) | 0.550 |
| 2 | 28.7 (1742/6074) | Reference | Reference | ||
| ≥ 3 | 28.2 (1415/5011) | 0.98 (0.90–1.06) | 0.595 | 0.98 (0.88–1.09) | 0.697 |
| Vaginal delivery | |||||
| Cesarean delivery only | 30.4 (123/404) | 1.09 (0.87–1.37) | 0.470 | ||
| Spontaneous | 28.4 (3056/10,762) | Reference | |||
| Instrumental | 30.2 (574/1902) | 1.09 (0.98–1.21) | 0.113 | ||
| Presentation | |||||
| Normal cephalic | 28.5 (3198/11,218) | Reference | |||
| Abnormal cephalic | 31.2 (177/597) | 1.14 (0.95–1.37) | 0.164 | ||
| Breech | 29.0 (255/879) | 1.03 (0.89–1.19) | 0.751 | ||
| Episiotomy | |||||
| No | 28.4 (3320/11,597) | Reference | |||
| Yes | 30.2 (310/1067) | 1.02 (0.89–1.17) | 0.769 | ||
| Birth weight (g) | |||||
| < 4000 | 29.2 (2374/8119) | Reference | |||
| ≥ 4000 | 27.6 (1255/4544) | 0.92 (0.85–1.01) | 0.053 | ||
| Head circumference (cm) | |||||
| < 36 | 29.8 (1302/4367) | Reference | Reference | ||
| ≥ 36 | 27.8 (2059/7410) | 0.91 (0.83–0.98) | 0.019 | 0.95 (0.86–1.05) | 0.292 |
| Perineal tear 3 or 4 | |||||
| No | 28.7 (3438/11,993) | Reference | |||
| Yes | 28.6 (192/671) | 1.00 (0.84–1.19) | 0.977 | ||
| Age at first delivery (years) | |||||
| < 25 | 28.9 (1884/6525) | Reference | |||
| ≥ 25 | 28.4 (1746/6139) | 0.98 (0.91–1.06) | 0.591 | ||
| Age at surgery (years) | |||||
| < 30 | 40.1 (27/66) | 1.76 (1.07–2.89) | 0.025 | 1.60 (0.87–2.96) | 0.129 |
| 30–39 | 29.0 (583/2008) | 1.04 (0.93–1.16) | 0.494 | 1.09 (0.95–1.24) | 0.231 |
| 40–49 | 28.2 (1796/6359) | Reference | Reference | ||
| 50–59 | 29.4 (1211/4125) | 1.06 (0.97–1.15) | 0.218 | 1.01(0.90–1.13) | 0.909 |
| 60–67 | 30.2 (195/646) | 1.10 (0.92–1.31) | 0.297 | 1.12 (0.86–1.44) | 0.402 |
| BMI at surgery (kg/m2) | |||||
| < 25 (normal) | 24.5 (1141/4666) | Reference | Reference | ||
| 25–29.9 (overweight) | 29.9 (1066/3570) | 1.32 (1.19–1.45) | < 0.001 | 1.25 (1.12–1.39) | < 0.001 |
| ≥ 30 (obese) | 36.1 (706/1958) | 1.74 (1.56–1.95) | < 0.001 | 1.54 (1.36–1.75) | < 0.001 |
| Time from last delivery until surgery (years) | |||||
| 0–9 | 27.9 (1081/3875) | 0.93 (0.85–1.02) | 0.156 | ||
| 10–19 | 29.3 (1391/4750) | Reference | |||
| 20–29 | 28.6 (831/2902) | 0.97 (0.88–1.07) | 0.544 | ||
| ≥ 30 | 28.9 (321/1109) | 0.98 (0.85–1.13) | 0.823 | ||
| Preoperative stress urinary incontinence index scoreb | |||||
| ≤ 6 (< 25th percentile) | 22.1 (529/2392) | Reference | Reference | ||
| 7–10 (25th–75th percentile) | 29.2 (2502/8583) | 1.45 (1.30–1.61) | < 0.001 | 1.22 (1.07–1.38) | 0.003 |
| 11–12 (> 75th percentile) | 37.4 (553/1478) | 2.11 (1.82–2.43) | < 0.001 | 1.42 (1.17–1.72) | < 0.001 |
| Preoperative cough-jump stress test (g) | |||||
| ≤ 13 (< 25th percentile) | 28.0 (898/3207) | Reference | Reference | ||
| 14–67 (25th–75th percentile) | 28.2 (1892/6704) | 1.01 (0.92–1.11) | 0.819 | 0.98 (0.87–1.11) | 0.786 |
| 68–482 (> 75th percentile) | 31.0 (1016/3281) | 1.15 (1.04–1.28) | 0.009 | 1.04 (0.91–1.71) | 0.528 |
| Preoperative urgency urinary incontinence index scorec | |||||
| 0–1 (< 25th percentile) | 21.8 (1192//5476) | Reference | Reference | ||
| 2–5 (25th–75th percentile) | 30.1 (1217/4049) | 1.62 (1.46–1.78) | < 0.001 | 1.57 (1.39–1.78) | < 0.001 |
| 6–8 (> 75th percentile) | 38.9 (1349/3469) | 2.99 (2.65–3.39) | < 0.001 | 2.48 (2.10–2.93) | < 0.001 |
| Preoperative post-void residual urine (ml) | |||||
| < 100 | 28.9 (3759/13,028) | Reference | |||
| > 100 | 31.2 (49/157) | 1.12 (0.80–1.57) | 0.517 | ||
| Preoperative maximum urinary flow rate (ml/s) | |||||
| ≥ 15 | 28.1 (2982/10,626) | Reference | |||
| < 15 | 31.5 (123/391) | 1.18 (0.95–1.46) | 0.143 | ||
| Type of mid-urethral sling | |||||
| Retropubic | 28.0 (2915/10,431) | Reference | |||
| Inside-out obturator | 32.4 (556/1717) | 1.23 (1.11–1.38) | < 0.001 | 1.18 (1.03–1.35) | 0.021 |
| Outside-in obturator | 30.2 (171/566) | 1.12 (0.93–1.34) | 0.243 | 1.26 (1.01–1.58) | 0.043 |
| Mini-sling | 34.8 (171/491) | 1.38 (1.14–1.67) | < 0.001 | 1.58 (1.24–2.01) | < 0.001 |
| Surgical complications | |||||
| No | 28.2 (3163/11,2236) | Reference | |||
| Yes | 33.0 (650/1969) | 1.26 (1.14–1.39) | < 0.001 | 1.26 (1.10–1.43) | < 0.001 |
Data are n (%) unless otherwise specified
Entries presented in bold indicates statistically significance (p < 0.05)
OR odds ratio, CI confidence interval, MUS mid-urethral sling, BMI body mass index
aPostoperative stress urinary incontinence index score > 0
bStress urinary index score is calculated from the validated NFIR questionnaire with range 0–12
cUrgency urinary index score is calculated from the validated NFIR questionnaire with range 0–8
*Not adjusted for obstetrical factors