{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T11:48:13Z","timestamp":1788608893969,"version":"build-2803163510"},"reference-count":29,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,10,24]],"date-time":"2018-10-24T00:00:00Z","timestamp":1540339200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To identify patient characteristics and surgical factors predictive of complications requiring mid\u2010urethral sling (<jats:styled-content style=\"fixed-case\">MUS<\/jats:styled-content>) revision\/removal.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Case\u2013control study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary academic centre in Canada.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>One hundred and seven women undergoing <jats:styled-content style=\"fixed-case\">MUS<\/jats:styled-content> revision\/removal between 2005 and 2016 were matched with 214 controls by date of index <jats:styled-content style=\"fixed-case\">MUS<\/jats:styled-content> procedure (2:1 ratio).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data on patient and surgical factors were obtained via manual electronic and paper chart review. Three sets of pre\u2010specified simple and multivariable logistic regression models were fitted to: (1) examine previously reported risk factors for <jats:styled-content style=\"fixed-case\">MUS<\/jats:styled-content> revision after primary surgical treatment; (2) identify preoperative predictors of <jats:styled-content style=\"fixed-case\">MUS<\/jats:styled-content> complications requiring revision\/removal; and (3) identify surgical factors associated with this outcome after adjusting for potential confounding factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Crude and adjusted odds ratios (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>s) with 95% confidence intervals (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>s) for patient and surgical factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median time to <jats:styled-content style=\"fixed-case\">MUS<\/jats:styled-content> revision was 153 days (interquartile range, <jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content> 49\u2013432 days). Active smoking status (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 2.29, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.13\u20134.63, <jats:italic>P<\/jats:italic> = 0.03), having had a previous hysterectomy (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 3.88, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 2.02\u20137.46, <jats:italic>P<\/jats:italic> &lt; 0.01), and undergoing concomitant pelvic organ prolapse surgery at the time of the index <jats:styled-content style=\"fixed-case\">MUS<\/jats:styled-content> procedure (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 2.63, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.32\u20135.52, <jats:italic>P<\/jats:italic> &lt; 0.01) were independently associated with the need for <jats:styled-content style=\"fixed-case\">MUS<\/jats:styled-content> revision\/removal. Sling type (obturator versus retropubic), method of tensioning (to cough versus over instrument), anaesthetic type, and estimated blood loss were not associated with this outcome in the analysis presented here.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Active smoking status, having had a previous hysterectomy, and undergoing concomitant surgery for pelvic organ prolapse are risk factors for requiring subsequent <jats:styled-content style=\"fixed-case\">MUS<\/jats:styled-content> revision\/removal.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Risk factors for sling revision include smoking, previous hysterectomy, and concomitant prolapse 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