Results
We identified 1,961 women with SUI
who underwent first-time midurethral sling surgery between 2003 and 2018
in CMUH, with a median age of 53.5 years (IQR, 46.4–64.0; Table
1 ). Surgical complications (i.e., secondary surgery and urinary
retention) occurred in 93 (4.7%) patients within 5 years following the
index operations.
Patients with surgical
complications were more likely to be older
(60.3 years vs 53.1 years), to
have a history of menopausal syndrome within 1 year prior to the index
operation (16.1% vs 9.6%), a medication history of oral antidiabetic
drug (OAD; 8.6% vs 3.9%), HRT (32.3% vs 13.7%),
slower AFR
(8.0 ml/s vs 10.0 ml/s), and
longer voiding time (45.4 s vs 33.0 s), compared with patients without
5-year surgical complications,.
We used multivariable Cox
proportional hazard modeling to investigate the risk factors associated
with 5-year surgical complications (Table 2 ). After including
age, diabetes mellitus, duration of surgery, menopausal syndrome or HRT,
AFR, and sling type in the full model,
only menopausal syndrome or HRT
(adjusted HR, 1.794; 95% CI, 1.055–3.050, p=0.0390) remained
significantly associated with the risk of 5-year surgical complications.
Subgroup analyses of patients characterized by age (≤65 years,
>65 years) and diabetes status showed that menopausal
syndrome or HRT remained associated with adverse outcomes in patients
aged ≤65 years (aHR, 2.164; 95% CI, 1.333-4.136; p for interaction =
0.3750) and in patients without diabetes (aHR, 2.302; 95% CI,
1.303-4.066; p for interaction = 0.0534) (Table 3 ).