{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T20:43:50Z","timestamp":1783975430417,"version":"3.55.0"},"reference-count":21,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2020,2,27]],"date-time":"2020-02-27T00:00:00Z","timestamp":1582761600000},"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":[[2020,7]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare vaginal closure with versus without sling excision in the management of vaginal sling exposure following mid\u2010urethral sling (MUS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Clinical retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary urogynaecological centre in Australia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Women with urodynamic stress urinary incontinence (SUI) who had a MUS (<jats:italic>n<\/jats:italic> = 2823) during 1999\u20132017 with a follow\u2010up period up to December 2018. Thirty\u2010three women (1%) had sling exposure and 31 required surgical intervention (1%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Clinical review with analysis of surgical database and patient records.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>The primary outcome was successful closure and resolution of exposure\u2010related symptoms without the need for re\u2010surgery. Secondary outcomes were repeat procedure and recurrent incontinence following revision.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mean follow up was 103\u00a0months. Of the 20 women with a primary excision and closure approach, 19 had successful closure. Seven of 11 women with simple vaginal closure without excision needed another surgery for recurrent mesh exposure. Recurrence of stress incontinence did not occur in any of the four who had \u2018successful\u2019 closure without excision. Of those who had sling division\/removal without a concomitant stress continence procedure, 32% (7\/22) required further surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Sling excision and repair have better outcomes with less recurrence of sling exposure compared with simple closure. Following sling removal, one of three women will develop SUI recurrence and require surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>#Slingexcision &amp;repair leads to less recurrence of exposure versus #simpleclosure for #slingmeshexposure.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.16149","type":"journal-article","created":{"date-parts":[[2020,2,3]],"date-time":"2020-02-03T18:40:11Z","timestamp":1580755211000},"page":"1027-1033","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Mid\u2010urethral sling revision for mesh exposure\u2013long\u2010term outcomes of two surgical techniques from a comparative clinical retrospective cohort study"],"prefix":"10.1111","volume":"127","author":[{"given":"D","family":"Karmakar","sequence":"first","affiliation":[{"name":"Department of Urogynaecology Mercy Hospital for Women Heidelberg Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"PL","family":"Dwyer","sequence":"additional","affiliation":[{"name":"Department of Urogynaecology Mercy Hospital for Women Heidelberg Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Nikpoor","sequence":"additional","affiliation":[{"name":"Department of Urogynaecology Mercy Hospital for Women Heidelberg Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,2,27]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002022"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.21037\/tau.2017.04.06"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-013-2207-7"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-009-0976-9"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.10051"},{"key":"e_1_2_6_7_1","first-page":"1306","article-title":"Transobturator urethral suspension: mini\u2010invasive procedure in the treatment of stress urinary incontinence in women","volume":"11","author":"Delorme E","year":"2001","journal-title":"Prog Urol"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/PL00014599"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00451721"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.12.025"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(05)60382-5"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2012.04.005"},{"issue":"2","key":"e_1_2_6_13_1","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1097\/AOG.0b013e31826d27e3","article-title":"Autologous graft for treatment of midurethral sling exposure without mesh excision","volume":"121","author":"Jeppson PC","year":"2013","journal-title":"Obstet Gynecol"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.4111\/kju.2010.51.6.416"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-016-2947-2"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2016.07.031"},{"key":"e_1_2_6_17_1","first-page":"CD006375","article-title":"Mid\u2010urethral sling operations for stress urinary incontinence in women","volume":"7","author":"Ford AA","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2017.02.3341"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2014.04.006"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ju.0000060119.43064.f6"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2007.01541.x"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-008-0653-4"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; 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