{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T20:43:51Z","timestamp":1783975431205,"version":"3.55.0"},"reference-count":26,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,4,22]],"date-time":"2024-04-22T00:00:00Z","timestamp":1713744000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100013374","name":"NIHR School for Primary Care Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100013374","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To examine long\u2010term complications in women with stress urinary incontinence (SUI) and pelvic organ prolapse (POP), with and without surgical mesh implants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Longitudinal open cohort study from 1 April 2006 (or 1 April 2012) to 30 November 2018.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>The Clinical Practice Research Datalink (CPRD) Gold database, which is linked to Hospital Episodes Statistics (HES) inpatient data, the HES Diagnostic Imaging Dataset (DID), Office for National Statistics mortality data and Index of Multiple Deprivation socio\u2010economic status data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Sample<\/jats:title><jats:p>Women aged \u226518\u2009years with a diagnostic SUI\/POP Read code.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Rates are estimated using negative binomial regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Rates of referrals for: psychological and pain services; urinalysis, C\u2010reactive protein (CRP) and erythrocyte sedimentation rate (ESR) testing; and pelvic ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) scans.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A cohort of 220\u2009544 women were eligible for inclusion; 74% (<jats:italic>n<\/jats:italic>\u2009=\u2009162\u2009687) had SUI, 37% (<jats:italic>n<\/jats:italic>\u2009=\u200982\u2009123) had POP and 11% (<jats:italic>n<\/jats:italic>\u2009=\u200924\u2009266) had both. Rates of psychological referrals and CT scans were lower in women with SUI mesh surgery, but this was offset by higher rates of CRP testing in women with SUI or POP mesh, MRI scans in women with SUI mesh, and urinalysis testing and referrals to pain clinics for women with POP mesh.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our results suggest a higher burden of morbidity in women with SUI\/POP mesh surgery, and that these women may require ongoing follow\u2010up in the primary care setting.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.17828","type":"journal-article","created":{"date-parts":[[2024,4,22]],"date-time":"2024-04-22T03:53:25Z","timestamp":1713758005000},"page":"1368-1377","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The long\u2010term impact of vaginal surgical mesh devices on pain clinic and psychological service referrals, anti\u2010inflammatory testing and pelvic scans in <scp>UK<\/scp> primary care: A cohort study with the Clinical Practice Research Datalink"],"prefix":"10.1111","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8981-8911","authenticated-orcid":false,"given":"Emily","family":"McFadden","sequence":"first","affiliation":[{"name":"Centre for Evidence\u2010Based Medicine, Nuffield Department of Primary Care Health Sciences University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1009-1992","authenticated-orcid":false,"given":"Carl","family":"Heneghan","sequence":"additional","affiliation":[{"name":"Centre for Evidence\u2010Based Medicine, Nuffield Department of Primary Care Health Sciences University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,4,22]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"First do no harm: the report of the Independent Medicines and Medical Devices safety review. Crown copyright;2020[cited 2024 April 17]. Available from:https:\/\/www.immdsreview.org.uk\/Report.html"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD004014.pub5"},{"key":"e_1_2_12_4_1","article-title":"Single\u2010incision sling operations for urinary incontinence in women","volume":"7","author":"Nambiar A","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-011-1384-5"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-017-11821-w"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.14997"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2021.08.059"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S333775"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.maturitas.2023.107829"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyv098"},{"key":"e_1_2_12_12_1","unstructured":"CPRD.HES diagnostic imaging dataset [Internet].2023[cited 2024 April 15]. Available from:https:\/\/cprd.com\/cprd\u2010linked\u2010data#HES\u2009Diagnostic\u2009Imaging\u2009Dataset"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.119.13926"},{"key":"e_1_2_12_14_1","volume-title":"Urinary incontinence and pelvic organ prolapse in women: management NG123","author":"NICE","year":"2019"},{"key":"e_1_2_12_15_1","unstructured":"Deborah Kotz.FDA strengthens requirements for surgical mesh for the transvaginal repair of pelvic organ prolapse to address safety risks | FDA [Internet]. FDA News Release;2016[cited 2023 Jan 25]. Available from:https:\/\/www.fda.gov\/news\u2010events\/press\u2010announcements\/fda\u2010strengthens\u2010requirements\u2010surgical\u2010mesh\u2010transvaginal\u2010repair\u2010pelvic\u2010organ\u2010prolapse\u2010address\u2010safety"},{"key":"e_1_2_12_16_1","volume-title":"Transvaginal mesh repair of anterior or posterior vaginal wall prolapse IPG599","author":"NICE","year":"2017"},{"key":"e_1_2_12_17_1","article-title":"Mid\u2010urethral sling operations for stress urinary incontinence in women","volume":"7","author":"Ford A","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_12_18_1","article-title":"Surgery for women with pelvic organ prolapse with or without stress urinary incontinence","volume":"8","author":"Baessler K","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_12_19_1","unstructured":"National Institute for Health and Care Excellence.2021 Exceptional surveillance of urinary incontinence and pelvic organ prolapse in women: management (NICE guideline NG123) surveillance report.2021[cited 2024 April 15]. 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