supplementary appendix · q08 (paired with icd10 diagnostic code n81) vaginal hysterectomy for...
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Supplementary appendixThis appendix formed part of the original submission and has been peer reviewed. We post it as supplied by the authors.
Supplement to: Morling JR, McAllister DA, Agur W, et al. Adverse events after first, single, mesh and non-mesh surgical procedures for stress urinary incontinence and pelvic organ prolapse in Scotland, 1997–2016: a population-based cohort study. Lancet 2016; published online Dec 20. http://dx.doi.org/10.1016/S0140-6736(16)32572-7.
ESM 1 Index procedure coding Index incontinence procedures: defined as the following OPCS-4 codes:
Open colposuspension (non mesh) M52.3 (not with Y50.8 to 31.3.06 or Y75 from 1.4.06)
Urethral injection therapy (non mesh) M56.3
Suprapubic sling (non mesh) M52.1
Unspecified mesh M53.8 to 31.3.06
Retropubic mesh M53.3 from 1.4.06
Transobturator mesh M53.6 from 1.4.06
Index prolapse procedures: defined as the following OPCS-4 codes:
Anterior colporrhaphy (non mesh) P23.2 or P23.5 (not with Y02, Y36 or Y37) (not with Q01 or Q08), (P23.5 from 1.4.06)
Anterior colporrhaphy with mesh P23.6 from 1.4.07 (Not with Q01 or Q08)
Posterior colporrhaphy (non mesh) P23.3 or P23.4 (Not with Y02, Y36 or Y37) (Not with Q01 or Q08)
Posterior colporrhaphy with mesh P23.7 from 1.4.07 (Not with Q01 or Q08)
Sacrospinous fixation of vagina (non mesh)
P24.4 to 31.3.06 or P24.7 from 1.4.06
Vaginal mesh vault repair (mesh) P24.6 from 1.4.06
Open sacrocolpopexy (abdominal mesh)
P24.2 or P24.5 (P24.5 from 1.4.06) (Not with Y50.8 to 31.3.06 or Y75 from1.4.06)
Vaginal hysterectomy for prolapse (non mesh)
Q08 (Paired with ICD10 diagnostic code N81)
Restricting to single procedures Women undergoing concurrent additional procedures for incontinence or prolapse were excluded. Concurrent/combination procedures were defined as any of the following OPCS4 codes (in addition to the specific index procedure codes listed above) occurring on the index procedure discharge record. For all procedures except sacrospinous fixation of vagina; open sacrocolpopexy; and vaginal mesh vault repair: M51-M58; P18: P22-P24: P26; Q54; Q07-Q08 For sacrospinous fixation of vagina; open sacrocolpopexy; and vaginal mesh vault repair: As above apart from the following concurrent codes (denoting anterior and/or posterior non mesh colporrhaphy without cervical amputation or vaginal hysterectomy) were specifically allowed as vault repair procedures were very rarely done without a concurrent procedure: P23.1-P23.5 (Not with Y02; Y36; Y37; Q01; Q08) Restricting to first procedures Women who had undergone a previous procedure for incontinence or prolapse were excluded. Prior procedures were defined as any of the following OPCS4 codes occurring on a previous hospital discharge record up to 5 years before index procedure. For all procedures except sacrospinous fixation of vagina; open sacrocolpopexy; and vaginal mesh vault repair:
M51-M58; P18: P22-P24: P26; Q54; Q07-Q08 paired with ICD10 diagnostic code N81 For sacrospinous fixation of vagina; open sacrocolpopexy; and vaginal mesh vault repair: As above apart from the following previous codes (denoting hysterectomy) were specifically allowed as vault repair procedures inevitably follow a prior hysterectomy: Q07-Q08
ESM 2 Outcome coding
Immediate procedural complication
Identification of complications likely to be related to the index event, for example urinary tract infection,
pain, sepsis.
‘Immediate procedural complication’ was defined as a qualifying ICD-10 code occurring during the index
procedure hospital stay where the patient was discharged within 90 days of their operation. Patients were
categorised as either having a complication during their initial hospital stay (regardless of how many
separate complication codes were recorded) or not.
Admission with a late procedural complication (within 5 years)
Identification of complications likely to be related to the index event but occurring after the index
admission.
‘Late procedural complication’ was defined as a qualifying ICD-10 or OPCS-4 code occurring during a
hospital stay subsequent to, and with a discharge date within 5 years of, the index procedure date. Each of
a patient’s subsequent admissions was categorised as indicating a complication or not (regardless of how
many separate complication codes were recorded) and counted separately.
Admission for further incontinence surgery (within 5 years)
Identification of hospital admissions for further incontinence surgery.
‘Readmission for further incontinence surgery’ was defined as a qualifying OPCS-4 code occurring during
a hospital stay subsequent to, and with a discharge date within 5 years of, the index procedure date. Each
of a patient’s subsequent admissions was categorised as indicating a further surgery event or not
(regardless of how many separate procedure codes were recorded) and counted separately.
Admission for further prolapse surgery (within 5 years)
Identification of hospital admissions for further prolapse surgery.
‘Readmission for further of prolapse surgery’ was defined as a qualifying OPCS-4 code occurring during a
hospital stay subsequent to, and with a discharge date within 5 years of, the index procedure date. Each of
a patient’s subsequent admissions was categorised as indicating a further surgery event or not (regardless
of how many separate procedure codes were recorded) and counted separately.
Adverse event outcome coding
Data
source Timing Codes
1. Immediate procedural complication
SMR01 During the index admission
and where the patient was
discharged within 90 days of
their operation
ICD10 diagnostic codes:
Haemorrhage related:
T81.0 Haemorrhage and haematoma complicating a procedure, NEC
T81.1 Shock during or resulting from a procedure, NEC
R58 Haemorrhage, NEC
Infection related:
T81.4 Infection following procedure, NEC
T83.5 Infection and inflammatory reaction due to prosthetic device, implant and graft in urinary system
T83.6 Infection and inflammatory reaction due to prosthetic device, implant and graft in genital tract
N30 Cystitis
N39.0 Urinary tract infection, site not specified
R30 Pain associated with micturition
R57.2 Septic shock
R65 Systemic inflammatory response syndrome
A40 Streptococcal sepsis
A41 Other sepsis
Pain related:
N94.1 Dyspareunia
R10.2 Pelvic and perineal pain
R52.1 Chronic intractable pain
R52.2 Other chronic pain
Procedure related:
T81.2 Accidental puncture and laceration during a procedure, not elsewhere classified
T81.3 Disruption of operation wound, NEC
T81.5 Foreign body accidentally left in body cavity or operation wound following a procedure
T81.6 Acute reaction to foreign substance accidentally left during a procedure
T81.7 Vascular complications following a procedure, NEC
T81.8 Other complications of procedures, NEC
T81.9 Unspecified complication of procedure
T83.0 Mechanical complication of urinary (indwelling) catheter
T83.1 Mechanical complication of other urinary devices and implants
T83.2 Mechanical complication of graft of urinary system
T83.3 Mechanical complication of intrauterine contraceptive device
T83.4 Mechanical complication of other prosthetic devices, implants and grafts in genital tract
T83.8 Other complications of genitourinary prosthetic devices, implants and grafts
T83.9 Unspecified complication of genitourinary prosthetic device, implant and graft
T88.8 Other specified complications of surgical and medical care, NEC
T88.9 Complication of surgical and medical care, unspecified
T98.3 Sequelae of complications of surgical and medical care, not elsewhere classified
Y60 Unintentional cut, puncture, perforation or haemorrhage during surgical and medical care
Y73 Gastroenterology and urology devices associated with adverse incidents
Y76 Obstetric and gynaecological devices associated with adverse incidents
Y83 Surgical operation and other surgical procedures as the cause of abnormal reaction of the patient, or of
later complication, without mention of misadventure at the time of the procedure
Y88 Sequelae with surgical and medical care as external cause
R33 Retention of urine
R39.1 Other difficulties with micturition
2. Late procedural complication
SMR01 During a subsequent
admission with discharge date
within 5 years of the date of
index procedure
ICD10 diagnostic codes:
Haemorrhage related:
T81.0* Haemorrhage and haematoma complicating a procedure, NEC
T81.1* Shock during or resulting from a procedure, NEC
R58* Haemorrhage, NEC
Infection related:
T81.4 Infection following procedure, NEC
T83.5 Infection and inflammatory reaction due to prosthetic device, implant and graft in urinary system
T83.6 Infection and inflammatory reaction due to prosthetic device, implant and graft in genital tract
N30* Cystitis
N39.0* Urinary tract infection, site not specified
R30* Pain associated with micturition
R57.2* Septic shock
R65* Systemic inflammatory response syndrome
A40* Streptococcal sepsis
A41* Other sepsis
Pain related:
N94.1 Dyspareunia
R10.2 Pelvic and perineal pain
R52.1 Chronic intractable pain
R52.2 Other chronic pain
Procedure related:
T81.2 Accidental puncture and laceration during a procedure, not elsewhere classified
T81.3 Disruption of operation wound, NEC
T81.5 Foreign body accidentally left in body cavity or operation wound following a procedure
T81.6 Acute reaction to foreign substance accidentally left during a procedure
T81.7 Vascular complications following a procedure, NEC
T81.8 Other complications of procedures, NEC
T81.9 Unspecified complication of procedure
T83.0 Mechanical complication of urinary (indwelling) catheter
T83.1 Mechanical complication of other urinary devices and implants
T83.2 Mechanical complication of graft of urinary system
T83.3 Mechanical complication of intrauterine contraceptive device
T83.4 Mechanical complication of other prosthetic devices, implants and grafts in genital tract
T83.8 Other complications of genitourinary prosthetic devices, implants and grafts
T83.9 Unspecified complication of genitourinary prosthetic device, implant and graft
T88.8 Other specified complications of surgical and medical care, NEC
T88.9 Complication of surgical and medical care, unspecified
T98.3 Sequelae of complications of surgical and medical care, not elsewhere classified
Y60* Unintentional cut, puncture, perforation or haemorrhage during surgical and medical care
Y73* Gastroenterology and urology devices associated with adverse incidents
Y76* Obstetric and gynaecological devices associated with adverse incidents
Y83 Surgical operation and other surgical procedures as the cause of abnormal reaction of the patient, or of
later complication, without mention of misadventure at the time of the procedure
Y88 Sequelae with surgical and medical care as external cause
R33* Retention of urine
R39.1* Other difficulties with micturition
OPCS4 procedure codes:
Mesh removal:
M53.4 Total removal of tension-free vaginal tape
M53.5 Partial removal of tension-free vaginal tape
M53.7 Removal of transobturator tape
P05, P20, P22.8, P23.8, or P29 paired with Y03 or Y26 Non specific vaginal prolapse repair or other procedure on
lower genital tract paired with supplementary code indicating 'attention to prosthesis' or 'other repair of organ' to
denote removal of prolapse mesh
*code only applicable if admission date within 90 days of the index procedure date
3. Further incontinence surgery
SMR01 During a subsequent
admission with discharge date
within 5 years of the date of
index procedure
OPSC4 procedural codes:
M51-M58 (excl. episodes with only code M53.4, M53.5 or M53.7) Any operation on outlet of female bladder
Note that M53,4, M53.5, and M53.7 have been excluded as these codes indicate removal of previously inserted
mesh tapes hence they indicate a complication rather than simply repeat continence surgery
4. Further prolapse surgery
SMR01 During a subsequent
admission with discharge date
within 5 years of the date of
index procedure
OPSC4 procedural codes:
P18, P22 (except P22.8 when paired with Y03 or Y26), P23 (except P23.8 when paired with Y03 or Y26), P24, P26,
Q54 Any procedure for pelvic organ prolapse
Q08 (paired with ICD10 diagnostic code N81 ) Vaginal hysterectomy for prolapse
Note that P22.8 and P23.8 codes have been excluded when paired with codes Y03 or Y26 as examination of the
PROSPECT validation data suggested these codes are used to code prolapse mesh removal rather than (or possibly
as well as) repeat colporrhaphy hence they are likely to indicate a complication rather than simply repeat prolapse
surgery. As such these codes are included in the list for late procedural complications
Further prolapse surgery codes classified by compartment operated on
Anterior
P22.1
P22.2
P23.1
P23.2
P23.5
P23.6
Posterior
P22.1
P22.3
P23.1
P23.3
P23.4
P23.7
Vault
P24
Other (includes uterine prolapse repair and unspecified procedures)
P18
P22.8 not paired with Y03 or Y26
P22.9
P23.8 not paired with Y03 or Y26
P23.9
P26
Q54
Q08 paired with ICD10 code N81
SMR Scottish Morbidity Record
ESM 3 Directed acyclic graph
Causal relationship underpinning analysis
ESM 4 Characteristics of patients undergoing first combined incontinence and prolapse procedures in Scotland, 1997/98-2015/16
i.e. the specified included procedure done at the same time as another incontinence or prolapse procedure (see ESM1 for codes used)
Incontinence surgery
Open colposuspension
(non mesh)
Urethral injection therapy
(non mesh)
Suprapubic sling
(non mesh) Unspecified mesh Retropubic mesh
Transobturator mesh
Number of patients 454 6 84 743 1094 966
Years 1997/98-2015/16 1997/98-2015/16 1997/98-2015/16 1997/98-2005/06 2006/07-2015/16 2006/07-2015/16
Age, years, mean (SD) 49.8 (10.2) 59.5 (15.7) 54.9 (10.9) 56.9 (12.0) 56.3 (12.4) 54.4 (11.9)
Most deprived quintile, % (number) 20.3 (92) 16.7 (1) 34.5 (29) 12.3 (91) 17.5 (191) 17.0 (162)
Co-morbidity, % (number) 3.7 (17) 16.7 (1) 14.3 (12) 8.5 (63) 7.2 (79) 8.9 (86)
Teaching hospital, % (number) 38.3 (174) 16.7 (1) 78.6 (66) 51.4 (382) 43.2 (473) 23.7 (229)
Low volume consultant, % (number) 74.7 (339) 50.0 (3) 42.9 (36) 41.6 (309) 40.0 (438) 39.0 (377)
Prolapse surgery
Anterior colporrhaphy
(non mesh)
Anterior colporrhaphy with mesh
Posterior colporrhaphy
(non mesh)
Posterior colporrhaphy with mesh
Sacrospinous fixation of vagina
(non mesh)
Vaginal mesh vault repair
(mesh)
Open sacrocolpopexy
(abdominal mesh)
Vaginal hysterectomy
(non mesh)
Number of patients 9656 379 3108 429 1231 289 461 12496
Years 1997/98-2015/16
2007/08-2015/16 1997/98-2015/16
2007/08-2015/16 1997/98-2015/16 2006/07-2015/16
1997/98-2015/16 1997/98-2015/16
Age, years, mean (SD)
62.5 (11.1) 61.7 (10.9) 59.8 (12.1) 59.7 (11.9) 62.3 (11.7) 59.6 (12.0) 60.3 (13.0) 62.7 (11.1)
Most deprived quintile, % (number)
14.7 (1409) 22.4 (85) 16.2 (501) 21.2 (91) 18.6 (228) 25.0 (72) 14.3 (66) 14.6 (1814)
Co-morbidity, % (number)
7.4 (712) 7.1 (27) 9.2 (287) 11.9 (51) 8.4 (104) 14.2 (41) 7.8 (36) 6.9 (860)
Teaching hospital, % (number)
29.3 (2834) 75.2 (285) 33.9 (1054) 49.7 (213) 49.2 (606) 5.9 (17) 47.7 (220) 30.1 (3763)
Low volume consultant, % (number)
75.2 (7265) 67.8 (257) 68.5 (2128) 53.4 (229) 66.5 (819) 12.5 (36) 73.8 (340) 80.3 (10032)
This table is directly comparable to Table 1 in the main paper showing characteristics of patients undergoing first single procedures.
Specifically, the percentage of operations performed by a low volume consultant has been derived in the same way for both tables: consultants performing an incontinence or
prolapse procedure are considered ‘low volume’ if they performed fewer than 20 included first single incontinence or prolapse procedures respectively in that year.
ESM 5 Index procedure frequency
Incontinence surgery
First single incontinence procedures in Scotland, 1997/98-2015/16
1997/
98 1998/
99 1999/
00 2000/
01 2001/
02 2002/
03 2003/
04 2004/
05 2005/
06 2006/
07 2007/
08 2008/
09 2009/
10 2010/
11 2011/
12 2012/
13 2013/
14 2014/
15 2015/
16 Total
Open colposuspension
(non mesh)
554 622 447 285 139 89 54 22 15 32 17 9 11 4 1 2 8 31 25 2367
Urethral injection therapy
(non mesh)
42 57 69 38 16 25 19 17 21 17 28 37 44 42 61 53 27 34 38 685
Suprapubic sling
(non mesh)
23 41 50 34 45 25 29 47 22 34 9 18 14 6 8 8 12 19 31 475
Unspecified mesh
5 3 21 234 511 585 733 726 837 - - - - - - - - - - 3655
Retropubic mesh
- - - - - - - - - 451 593 666 629 478 478 562 465 188 118 4628
Transobturator mesh
- - - - - - - - - 370 597 710 735 679 606 608 389 129 27 4850
Total 624 723 587 591 711 724 835 812 895 904 1244 1440 1433 1209 1154 1233 901 401 239 16660
Prolapse surgery
First single prolapse procedures in Scotland, 1997/98-2015/16
1997/
98 1998/
99 1999/
00 2000/
01 2001/
02 2002/
03 2003/
04 2004/
05 2005/
06 2006/
07 2007/
08 2008/
09 2009/
10 2010/
11 2011/
12 2012/
13 2013/
14 2014/
15 2015/
16 Total
Anterior colporrhaphy
(non mesh)
363 396 317 346 298 367 409 408 432 412 404 506 513 411 515 449 455 381 261 7643
Anterior colporrhaphy
with mesh - - - - - - - - - - 23 38 44 49 60 44 18 1 1 278
Posterior colporrhaphy
(non mesh)
302 270 296 274 250 312 321 305 312 301 283 397 408 348 346 424 352 335 225 6061
Posterior colporrhaphy
with mesh - - - - - - - - - - 22 18 23 37 66 34 5 4 0 209
Sacrospinous fixation of
vagina
(non mesh)
5 4 3 6 6 7 21 38 33 61 103 137 163 137 154 247 376 300 257 2058
Vaginal mesh vault repair
(mesh)
- - - - - - - - - 18 25 15 24 14 5 4 4 1 2 112
Open sacrocolpope
xy
(abdominal mesh)
40 78 50 81 71 47 42 40 79 22 16 16 10 9 17 32 8 12 10 680
Vaginal hysterectomy
(non mesh)
111 123 118 110 87 89 100 96 98 135 114 113 112 135 120 84 70 72 58 1945
Total 821 871 784 817 712 822 893 887 954 949 990 1240 1297 1140 1283 1318 1288 1106 814 1898
6
ESM 6 Index procedure length of inpatient stay
Length of stay in days for complete index procedure inpatient admission including any transfers between units
Length of stay in days, median (interquartile range)
Incontinence surgery
Open colposuspension (non mesh) 6 (5-8)
Urethral injection therapy (non mesh) 1 (0-2)
Suprapubic sling (non mesh) 3 (2-5)
Unspecified mesh 2 (1-2)
Retropubic mesh 1 (0-1)
Transobturator mesh 1 (0-2)
Prolapse surgery
Anterior colporrhaphy (non mesh) 3 (2-5)
Anterior colporrhaphy with mesh 4 (3-4)
Posterior colporrhaphy (non mesh) 3 (2-4)
Posterior colporrhaphy with mesh 3 (3-4)
Sacrospinous fixation of vagina (non mesh) 3 (2-4)
Vaginal mesh vault repair (mesh) 4 (3-5)
Open sacrocolpopexy (abdominal mesh) 5 (4-6)
Vaginal hysterectomy (non mesh) 4 (3-5)
ESM 7 Immediate and late complications by complication subgroups
Incontinence surgery
Open colposuspension
(non mesh)
Urethral injection therapy
(non mesh)
Suprapubic sling
(non mesh)
Unspecified mesh
Retropubic mesh Transobturator
mesh
Number of patients 2367 685 475 3655 4628 4850
Years 1997/98-2015/16
1997/98-2015/16
1997/98-2015/16
1997/98-2005/06
2006/07-2015/16
2006/07-2015/16
[A] Immediate postoperative complications
Patients with a haemorrhage related immediate complication, % (n) 0·8 (18) 0·0 (0) 0·4 (2) 0·7 (25) 0·3 (15) 0·2 (11)
Patients with an infection related immediate complication, % (n) 4·9 (117) 5·4 (37) 2·1 (10) 2·2 (80) 0·9 (42) 0·7 (35)
Patients with a pain related immediate complication, % (n) 0·2 (4) 0·1 (1) 0·2 (1) 0·3 (11) 0·2 (8) 0·3 (13)
Patients with a procedure related immediate complication, % (n) 5·2 (124) 2·8 (19) 4·2 (20) 4·8 (175) 2·6 (122) 1·6 (77)
Patients with any immediate complication, % (n) 7·8 (185) 8·2 (56) 5·7 (27) 7·1 (258) 3·7 (169) 2·5 (120)
[B] Late postoperative complication admissions
Total person-years of follow-up 11454 2832 2090 18074 19608 21378
Haemorrhage related late complication admissions, CIR (n) 2·1 (24) 0·0 (0) 1·9 (4) 0·7 (13) 0·5 (10) 0·3 (7)
Infection related late complication admissions, CIR (n) 12·0 (137) 54·0 (153) 23·0 (48) 12·7 (230) 14·1 (277) 14·2 (304)
Pain related late complication admissions, CIR (n) 0·4 (5) 0·4 (1) 0·5 (1) 0·3 (5) 0·3 (6) 0·1 (2)
Procedure related late complication admissions, CIR (n) 29·2 (335) 54·0 (153) 44·0 (92) 28·1 (508) 29·3 (574) 26·6 (569)
Mesh removal related late complication admissions, CIR (n) 2·0 (23) 2·1 (6) 10·0 (21) 4·6 (84) 10·9 (214) 8·3 (178)
Any late complication admission, CIR (n) 34·1 (391) 88·6 (251) 54·1 (113) 33·9 (612) 35·6 (698) 33·0 (706)
Prolapse surgery
Anterior colporrhaphy
(non mesh)
Anterior colporrhaphy with mesh
Posterior colporrhaphy
(non mesh)
Posterior colporrhaphy with mesh
Sacrospinous fixation of vagina
(non mesh)
Vaginal mesh vault repair
(mesh)
Open sacrocolpopexy
(abdominal mesh)
Vaginal hysterectomy
(non mesh)
Number of patients 7643 278 6061 209 2058 112 680 1945
Years 1997/98-2015/16
2007/08-2015/16
1997/98-2015/16
2007/08-2015/16
1997/98-2015/16
2006/07-2015/16
1997/98-2015/16
1997/98-2015/16
[A] Immediate postoperative complications
Patients with a haemorrhage related immediate complication, % (n) 0·3 (22) 0·4 (1) 0·6 (37) 0·0 (0) 0·6 (13) 0·0 (0) 1·2 (8) 1·8 (35)
Patients with an infection related immediate complication, % (n) 2·4 (186) 1·4 (4) 1·5 (90) 0·5 (1) 1·7 (36) 0·9 (1) 3·8 (26) 1·5 (29)
Patients with a pain related immediate complication, % (n) 0·1 (5) 0·0 (0) 0·3 (16) 0·5 (1) 0·0 (1) 0·0 (0) 0·3 (2) 0·5 (10)
Patients with a procedure related immediate complication, % (n) 2·4 (187) 2·5 (7) 1·8 (109) 1·0 (2) 3·0 (61) 3·6 (4) 3·5 (24) 3·8 (73)
Patients with any immediate complication, % (n) 4·5 (343) 3·6 (10) 3·3 (199) 1·4 (3) 4·4 (91) 4·5 (5) 6·3 (43) 5·4 (105)
[B] Late postoperative complication admissions
Total person-years of follow-up 33205 1236 26000 934 6562 518 3127 8726
Haemorrhage related late complication admissions, CIR (n) 1·9 (62) 1·6 (2) 3·3 (85) 2·1 (2) 3·4 (22) 9·7 (5) 1·9 (6) 4·8 (42)
Infection related late complication admissions, CIR (n) 5·1 (170) 35·6 (44) 6·7 (175) 32·1 (30) 9·6 (63) 29·0 (15) 15·4 (48) 6·3 (55)
Pain related late complication admissions, CIR (n) 0·2 (7) 0·0 (0) 0·4 (11) 0·0 (0) 0·3 (2) 0·0 (0) 0·0 (0) 0·7 (6)
Procedure related late complication admissions, CIR (n) 17·5 (582) 58·3 (72) 20·6 (536) 64·2 (60) 30·2 (198) 44·4 (23) 30·7 (96) 18·5 (161)
Mesh removal related late complication admissions, CIR (n) 3·6 (120) 29·1 (36) 5·0 (130) 31·0 (29) 10·4 (68) 29·0 (15) 9·3 (29) 5·0 (44)
Any late complication admission, CIR (n) 22·0 (730) 70·4 (87) 25·9 (673) 77·1 (72) 39·5 (259) 52·1 (27) 38·7 (121) 24·9 (217)
CIR is crude incidence rate per 1000 person-years calculated as [number of late complication admissions/total person-years of follow-up]*1000
The number of patients with immediate complications in each subgroup can sum to greater than the total number of patients with any immediate complication as more than one complication type may be recorded on an index procedure
record.
Similarly, the number of late complication admissions in each subgroup can sum to greater than the total number of late complication admissions as more than one complication type may be recorded on a readmission record.
Patients with non-mesh index procedures may have subsequent mesh removal related late complication admissions if they had a mesh procedure after their index procedure.
ESM 8 Deviance and residual degrees of freedom for all Poisson regression models
Main/subgroup Outcome modelled Covariates Residual deviance
Residual degrees of freedom
Ratio of residual deviance to degrees of freedom
Full model, incontinence Patients with a complication, % (n) Unadjusted 4739·43 16580 0·29
Full model, incontinence Any late complication admission, CIR (n) Unadjusted 13946·62 16580 0·84
Full model, incontinence Further incontience surgery Unadjusted 6721·30 16580 0·41
Full model, incontinence Further prolapse surgery Unadjusted 3809·47 16580 0·23
Full model, incontinence Patients with a complication, % (n) Adjusted 4685·85 16570 0·28
Full model, incontinence Any late complication admission, CIR (n) Adjusted 13784·86 16570 0·83
Full model, incontinence Further incontience surgery Adjusted 6695·65 16570 0·40
Full model, incontinence Further prolapse surgery Adjusted 3793·22 16570 0·23
Full model, prolapse Patients with a complication, % (n) Unadjusted 5022·05 18877 0·27
Full model, prolapse Any late complication admission, CIR (n) Unadjusted 11842·83 18877 0·63
Full model, prolapse Further incontience surgery Unadjusted 3894·22 18877 0·21
Full model, prolapse Further prolapse surgery Unadjusted 10388·08 18877 0·55
Full model, prolapse Patients with a complication, % (n) Adjusted 4994·56 18867 0·26
Full model, prolapse Any late complication admission, CIR (n) Adjusted 11735·10 18867 0·62
Full model, prolapse Further incontience surgery Adjusted 3811·14 18867 0·20
Full model, prolapse Further prolapse surgery Adjusted 10302·29 18867 0·55
Retropubic vs transobturator model Patients with a complication, % (n) Unadjusted 1999·17 9422 0·21
Retropubic vs transobturator model Any late complication admission, CIR (n) Unadjusted 7471·27 9422 0·79
Retropubic vs transobturator model Further incontience surgery Unadjusted 3214·60 9422 0·34
Retropubic vs transobturator model Further prolapse surgery Unadjusted 1636·00 9422 0·17
Retropubic vs transobturator model Patients with a complication, % (n) Adjusted 1969·88 9412 0·21
Retropubic vs transobturator model Any late complication admission, CIR (n) Adjusted 7298·22 9412 0·78
Retropubic vs transobturator model Further incontience surgery Adjusted 3196·05 9412 0·34
Retropubic vs transobturator model Further prolapse surgery Adjusted 1612·90 9412 0·17
Anterior compartment prolapse model Patients with a complication, % (n) Unadjusted 1032·28 4142 0·25
Anterior compartment prolapse model Any late complication admission, CIR (n) Unadjusted 2360·54 4142 0·57
Anterior compartment prolapse model Further incontience surgery Unadjusted 833·20 4142 0·20
Anterior compartment prolapse model Further prolapse surgery Unadjusted 2201·06 4142 0·53
Anterior compartment prolapse model Patients with a complication, % (n) Adjusted 1006·36 4132 0·24
Anterior compartment prolapse model Any late complication admission, CIR (n) Adjusted 2328·16 4132 0·56
Anterior compartment prolapse model Further incontience surgery Adjusted 809·12 4132 0·20
Anterior compartment prolapse model Further prolapse surgery Adjusted 2157·57 4132 0·52
Posterior compartment prolapse model Patients with a complication, % (n) Unadjusted 656·65 3293 0·20
Posterior compartment prolapse model Any late complication admission, CIR (n) Unadjusted 1996·63 3293 0·61
Posterior compartment prolapse model Further incontience surgery Unadjusted 601·56 3293 0·18
Posterior compartment prolapse model Further prolapse surgery Unadjusted 1483·01 3293 0·45
Posterior compartment prolapse model Patients with a complication, % (n) Adjusted 639·59 3283 0·19
Posterior compartment prolapse model Any late complication admission, CIR (n) Adjusted 1963·46 3283 0·60
Posterior compartment prolapse model Further incontience surgery Adjusted 577·56 3283 0·18
Posterior compartment prolapse model Further prolapse surgery Adjusted 1470·36 3283 0·45
Vaginal vault prolapse model Patients with a complication, % (n) Unadjusted 615·63 2193 0·28
Vaginal vault prolapse model Any late complication admission, CIR (n) Unadjusted 1493·63 2193 0·68
Vaginal vault prolapse model Further incontience surgery Unadjusted 331·96 2193 0·15
Vaginal vault prolapse model Further prolapse surgery Unadjusted 1269·95 2193 0·58
Vaginal vault prolapse model Patients with a complication, % (n) Adjusted 609·33 2183 0·28
Vaginal vault prolapse model Any late complication admission, CIR (n) Adjusted 1453·91 2183 0·67
Vaginal vault prolapse model Further incontience surgery Adjusted 315·53 2183 0·14
Vaginal vault prolapse model Further prolapse surgery Adjusted 1248·63 2183 0·57
Further prolapse , by compartment model Further prolapse surgery, same compartment Unadjusted 4360·19 16938 0·26
Further prolapse , by compartment model Further prolapse surgery, different compartment Unadjusted 7938·80 16938 0·47
Further prolapse , by compartment model Further prolapse surgery, same compartment Adjusted 4287·97 16928 0·25
Further prolapse , by compartment model Further prolapse surgery, different compartment Adjusted 7894·18 16928 0·47
Anterior compartment prolapse model Further prolapse surgery, same compartment Unadjusted 1243·20 4142 0·30
Anterior compartment prolapse model Further prolapse surgery, different compartment Unadjusted 1801·86 4142 0·44
Anterior compartment prolapse model Further prolapse surgery, same compartment Adjusted 1231·70 4132 0·30
Anterior compartment prolapse model Further prolapse surgery, different compartment Adjusted 1769·53 4132 0·43
Posterior compartment prolapse model Further prolapse surgery, same compartment Unadjusted 445·18 3293 0·14
Posterior compartment prolapse model Further prolapse surgery, different compartment Unadjusted 1399·26 3293 0·42
Posterior compartment prolapse model Further prolapse surgery, same compartment Adjusted 437·62 3283 0·13
Posterior compartment prolapse model Further prolapse surgery, different compartment Adjusted 1378·92 3283 0·42
Vaginal vault prolapse model Further prolapse surgery, same compartment Unadjusted 633·39 2193 0·29
Vaginal vault prolapse model Further prolapse surgery, different compartment Unadjusted 1155·21 2193 0·53
Vaginal vault prolapse model Further prolapse surgery, same compartment Adjusted 613·95 2183 0·28
Vaginal vault prolapse model Further prolapse surgery, different compartment Adjusted 1130·67 2183 0·52
●
●
●
●
●
0.03 0.04 0.05 0.06 0.07 0.08
0.03
0.05
0.07
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)Full model, incontinence Immediate complications
Unadjusted
●
●
●
●
●
●
0.1 0.2 0.3 0.4
0.15
0.25
0.35
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)
Full model, incontinence Later complication
Unadjusted
●●
●●
●
●
0.1 0.2 0.3 0.4
0.1
0.2
0.3
0.4
0.5
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)
Full model, incontinence Further incontience surgery
Unadjusted
●
●
●
●
●
●
0.02 0.04 0.06 0.08
0.02
0.04
0.06
0.08
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)Full model, incontinence Further prolapse surgery
Unadjusted
●
●
●
●
●
●
0.05 0.10 0.15
0.00
0.05
0.10
0.15
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)Full model, incontinence Immediate complications
Adjusted
●●
●
●
●
●
0.2 0.4 0.6 0.8
0.5
1.0
1.5
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)
Full model, incontinence Later complication
Adjusted
●
●
●
●●
●
0.1 0.2 0.3 0.4 0.5 0.6
0.2
0.4
0.6
0.8
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)
Full model, incontinence Further incontience surgery
Adjusted
●
●
●
●
●
●
0.02 0.06 0.10 0.14
0.05
0.10
0.15
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)Full model, incontinence Further prolapse surgery
Adjusted
●
●
●
●
●
0.02 0.03 0.04 0.05 0.06
0.02
0.04
0.06
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)Full model, prolapse
Immediate complications Unadjusted
●
●
●
●
●
●
0.05 0.15 0.25 0.35
0.10
0.20
0.30
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)
Full model, prolapse Later complication
Unadjusted
●
●
●
●
●
●
0.02 0.04 0.06 0.08 0.10
0.02
0.06
0.10
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)
Full model, prolapse Further incontience surgery
Unadjusted
●
●
●
●
●
●
0.05 0.10 0.15 0.20 0.25
0.05
0.10
0.15
0.20
0.25
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)Full model, prolapse
Further prolapse surgery Unadjusted
●
●
● ●
●
●
0.04 0.06 0.08 0.10 0.12
0.03
0.05
0.07
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)Full model, prolapse
Immediate complications Adjusted
●●
●
● ●
●
0.1 0.2 0.3 0.4 0.5 0.6 0.7
0.2
0.4
0.6
0.8
1.0
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)
Full model, prolapse Later complication
Adjusted
●
●●
●
●
●
0.05 0.15 0.25
0.0
0.2
0.4
0.6
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)
Full model, prolapse Further incontience surgery
Adjusted
●
●
●
●
●
●
0.1 0.2 0.3 0.4
0.10
0.20
0.30
0.40
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)Full model, prolapse
Further prolapse surgery Adjusted
●
●
0.026 0.030 0.034
0.02
60.
030
0.03
4
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)Retropubic vs transobturator model
Immediate complications Unadjusted
●
●
●
●
●
●
0.05 0.10 0.15
0.06
0.10
0.14
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)
Retropubic vs transobturator model Later complication
Unadjusted
●
●
●
●
●
●
0.01 0.02 0.03 0.04 0.05 0.06
0.01
0.03
0.05
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)
Retropubic vs transobturator model Further incontience surgery
Unadjusted
●
●
●
●●
●
0.005 0.010 0.015 0.020 0.025
0.00
00.
010
0.02
0
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)Retropubic vs transobturator model
Further prolapse surgery Unadjusted
●●
●
●
●
●
0.02 0.04 0.06 0.08
0.02
0.06
0.10
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)Retropubic vs transobturator model
Immediate complications Adjusted
●
●
●
●
●●
0.1 0.2 0.3 0.4 0.5 0.6
0.10
0.20
0.30
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)
Retropubic vs transobturator model Later complication
Adjusted
●
●
●
●●
●
0.02 0.04 0.06 0.08 0.10 0.12
0.05
0.10
0.15
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)
Retropubic vs transobturator model Further incontience surgery
Adjusted
●
●
●●
●
●
0.01 0.02 0.03 0.04 0.05
0.00
0.02
0.04
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)Retropubic vs transobturator model
Further prolapse surgery Adjusted
●
●
0.0360 0.0370 0.0380
0.03
600.
0370
0.03
80
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)Anterior compartment prolapse model
Immediate complications Unadjusted
●
●● ●
●
●
0.05 0.15 0.25 0.35
0.05
0.15
0.25
0.35
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)
Anterior compartment prolapse model Later complication
Unadjusted
●
●
●
●
●
●
0.02 0.04 0.06 0.08 0.10
0.02
0.06
0.10
0.14
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)
Anterior compartment prolapse model Further incontience surgery
Unadjusted
●
●
●
●
●
●
0.05 0.10 0.15 0.20 0.25
0.05
0.15
0.25
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)Anterior compartment prolapse model
Further prolapse surgery Unadjusted
●●
●
●
●
●
0.05 0.10 0.15
0.1
0.2
0.3
0.4
0.5
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)Anterior compartment prolapse model
Immediate complications Adjusted
● ●● ●
●
●
0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8
0.0
1.0
2.0
3.0
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)
Anterior compartment prolapse model Later complication
Adjusted
●
●
●
●
●
●
0.05 0.15 0.25 0.35
0.05
0.10
0.15
0.20
0.25
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)
Anterior compartment prolapse model Further incontience surgery
Adjusted
●
●
●
●
●
●
0.1 0.2 0.3 0.4 0.5 0.6
0.2
0.4
0.6
0.8
1.0
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)Anterior compartment prolapse model
Further prolapse surgery Adjusted
●
●
0.015 0.020 0.025
0.01
50.
020
0.02
5
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)Posterior compartment prolapse model
Immediate complications Unadjusted
●
●
●
●
●
●
0.05 0.15 0.25 0.35
0.10
0.20
0.30
0.40
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)
Posterior compartment prolapse model Later complication
Unadjusted
●
●
●
●
●
●
0.01 0.02 0.03 0.04
0.00
0.02
0.04
0.06
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)
Posterior compartment prolapse model Further incontience surgery
Unadjusted
●
●
●
●
●
●
0.05 0.10 0.15 0.20
0.05
0.10
0.15
0.20
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)Posterior compartment prolapse model
Further prolapse surgery Unadjusted
●
●
●
●
●
●
0.02 0.04 0.06 0.08 0.10 0.12
0.00
0.04
0.08
0.12
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)Posterior compartment prolapse model
Immediate complications Adjusted
●
●
●
●
●
●
0.1 0.2 0.3 0.4 0.5 0.6 0.7
0.1
0.2
0.3
0.4
0.5
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)
Posterior compartment prolapse model Later complication
Adjusted
●
●
●
●
●
●
0.05 0.10 0.15
0.00
0.05
0.10
0.15
0.20
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)
Posterior compartment prolapse model Further incontience surgery
Adjusted
●
●
● ●
●
●
0.05 0.10 0.15 0.20 0.25
0.05
0.15
0.25
0.35
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)Posterior compartment prolapse model
Further prolapse surgery Adjusted
●
●
0.045 0.055 0.065
0.04
50.
055
0.06
5
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)Vaginal vault prolapse model
Immediate complications Unadjusted
●
●
●
●
●
●
0.05 0.10 0.15 0.20 0.25
0.10
0.14
0.18
0.22
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)
Vaginal vault prolapse model Later complication
Unadjusted
●
●
●
●
●
●
0.01 0.02 0.03 0.04
0.00
0.01
0.02
0.03
0.04
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)
Vaginal vault prolapse model Further incontience surgery
Unadjusted
●
●
●
●
●
●
0.05 0.10 0.15 0.20
0.00
0.05
0.10
0.15
0.20
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)Vaginal vault prolapse model
Further prolapse surgery Unadjusted
● ●
●
●
●
●
0.04 0.06 0.08 0.10 0.12
0.00
0.10
0.20
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)Vaginal vault prolapse model
Immediate complications Adjusted
● ●●
●
●
●
0.1 0.2 0.3 0.4
0.2
0.4
0.6
0.8
1.0
1.2
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)
Vaginal vault prolapse model Later complication
Adjusted
●
●
● ●
● ●
0.02 0.06 0.10 0.14
0.00
0.02
0.04
0.06
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)
Vaginal vault prolapse model Further incontience surgery
Adjusted
●
●
●
●
●
●
0.1 0.2 0.3 0.4 0.5 0.6
0.0
0.1
0.2
0.3
0.4
0.5
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)Vaginal vault prolapse model
Further prolapse surgery Adjusted
●
●
● ●
●
●
0.02 0.04 0.06 0.08
0.01
0.03
0.05
0.07
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)Further prolapse , by compartment model
Further prolapse surgery, same compartment Unadjusted
●
●
●
●
●
●
0.05 0.10 0.15 0.20
0.05
0.10
0.15
0.20
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)
Further prolapse , by compartment model Further prolapse surgery, different compartment
Unadjusted
●
●
●
●
●
●
0.05 0.10 0.15 0.20
0.00
0.10
0.20
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)
Further prolapse , by compartment model Further prolapse surgery, same compartment
Adjusted
●
●
●
●
●
●
0.05 0.10 0.15 0.20 0.25 0.30
0.05
0.15
0.25
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)Further prolapse , by compartment model
Further prolapse surgery, different compartment Adjusted
●
●
●●
●
●
0.02 0.04 0.06 0.08
0.00
0.04
0.08
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)Anterior compartment prolapse model
Further prolapse surgery, same compartment Unadjusted
●
●
●
●
●
●
0.05 0.10 0.15 0.20
0.05
0.10
0.15
0.20
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)
Anterior compartment prolapse model Further prolapse surgery, different compartment
Unadjusted
●●
●
●
●
●
0.02 0.06 0.10 0.14
0.05
0.15
0.25
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)
Anterior compartment prolapse model Further prolapse surgery, same compartment
Adjusted
●
●
●
● ●
●
0.1 0.2 0.3 0.4
0.05
0.15
0.25
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)Anterior compartment prolapse model
Further prolapse surgery, different compartment Adjusted
● ●
●
●
●
●
0.01 0.02 0.03 0.04
0.00
0.02
0.04
0.06
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)Posterior compartment prolapse model
Further prolapse surgery, same compartment Unadjusted
●
●
●
●
●
●
0.05 0.10 0.15 0.20
0.05
0.15
0.25
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)
Posterior compartment prolapse model Further prolapse surgery, different compartment
Unadjusted
●
●
●
● ● ●
0.02 0.06 0.10 0.14
0.00
0.04
0.08
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)
Posterior compartment prolapse model Further prolapse surgery, same compartment
Adjusted
●
●●
●
●
●
0.05 0.15 0.25 0.35
0.1
0.2
0.3
0.4
0.5
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)Posterior compartment prolapse model
Further prolapse surgery, different compartment Adjusted
●
●
●
●
●
●
0.01 0.03 0.05 0.07
0.00
0.02
0.04
0.06
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)Vaginal vault prolapse model
Further prolapse surgery, same compartment Unadjusted
●
●
●
●
●
●
0.05 0.10 0.15
0.00
0.05
0.10
0.15
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)
Vaginal vault prolapse model Further prolapse surgery, different compartment
Unadjusted
●
●
●
●
●
●
0.05 0.10 0.15
0.04
0.08
0.12
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)
Vaginal vault prolapse model Further prolapse surgery, same compartment
Adjusted
● ●
●
●
●
●
0.1 0.2 0.3 0.4 0.5
0.0
0.2
0.4
0.6
Predicted
Obs
erve
d (p
oint
s) a
nd p
redi
cted
(lin
e)Vaginal vault prolapse model
Further prolapse surgery, different compartment Adjusted
ESM 10 Further prolapse surgery on same and different anatomical compartment following first single prolapse procedures
Anterior colporrhaphy
(non mesh)
Anterior colporrhaphy with mesh
Posterior colporrhaphy
(non mesh)
Posterior colporrhaphy with mesh
Sacrospinous fixation of vagina
(non mesh)
Vaginal mesh vault repair
(mesh)
Open sacrocolpopexy
(abdominal mesh)
Number of patients 7643 278 6061 209 2058 112 680
Years 1997/98-2015/16 2007/08-2015/16 1997/98-2015/16 2007/08-2015/16 1997/98-2015/16 2006/07-2015/16
1997/98-2015/16
Total person-years of follow-up
33205 1236 26000 934 6562 518 3127
All further prolapse surgery
Total number of admissions within 5 years
990 66 584 38 313 21 170
Crude incidence rate per 1,000 person-years
29·8 53·4 22·5 40·7 47·7 40·5 54·4
Further prolapse surgery, same compartment
Total number of admissions within 5 years
384 21 127 9 100 8 54
Crude incidence rate per 1,000 person-years
11·6 17·0 4·9 9·6 15·2 15·4 17·3
Unadjusted IRR (95% CI) 1 (ref)
1·47 (0·94-2·27) 0·42 (0·35-0·52) 0·83 (0·43-1·61) 1·32 (1·06-1·64) 1·33 (0·66-2·68) 1·49 (1·12-1·98)
Adjusted IRR (95% CI) 1·23 (0·79-1·92) 0·40 (0·32-0·49) 0·68 (0·35-1·32) 1·26 (1·01-1·58) 1·23 (0·61-2·50) 1·57 (1·18-2·10)
Further prolapse surgery, different or unspecified compartment
Total number of admissions within 5 years
631 52 475 38 254 15 131
Crude incidence rate per 1,000 person-years
19·0 42·1 18·3 40·7 38·7 29·0 41·9
Unadjusted IRR (95% CI) 1 (ref)
2·21 (1·67-2·94) 0·97 (0·86-1·09) 2·14 (1·54-2·97) 2·04 (1·76-2·36) 1·52 (0·91-2·54) 2·20 (1·83-2·66)
Adjusted IRR (95% CI) 2·11 (1·58-2·81) 0·94 (0·83-1·06) 1·94 (1·39-2·70) 2·01 (1·73-2·33) 1·41 (0·84-2·36) 2·35 (1·94-2·85)
IRR incidence rate ratio
ESM 11 Direct comparison of further prolapse surgery on same and different anatomical compartment following specific mesh and non mesh first single procedures for prolapse, by anatomical compartment of index procedure
Anterior compartment prolapse Posterior compartment prolapse Vaginal vault prolapse
Anterior colporrhaphy
(non mesh)
Anterior colporrhaphy with mesh
Posterior colporrhaphy
(non mesh)
Posterior colporrhaphy with mesh
Sacrospinous fixation of vagina
(non mesh)
Vaginal mesh vault repair
(mesh)
Open sacrocolpopexy
(abdominal mesh)
Number of patients 3866 278 3086 209 1932 112 152
Years 2007/08-2015/16 2007/08- 2015/16 2007/08-2015/16 2007/08-2015/16 2006/07-2015/16 2006/07-2015/16 2006/07-2015/16
Further prolapse surgery, same compartment
Unadjusted IRR (95% CI) 1 (ref)
1·31 (0·83-2·05) 1 (ref)
2·35 (1·15-4·79) 1 (ref)
0·99 (0·48-2·03) 0·65 (0·28-1·48)
Adjusted IRR (95% CI) 1·22 (0·77-1·93) 2·26 (1·07-4·74) 0·95 (0·45-1·99) 0·68 (0·30-1·58)
Further prolapse surgery, different or unspecified compartment
Unadjusted IRR (95% CI) 1 (ref)
2·15 (1·60-2·88) 1 (ref)
2·07 (1·47-2·92) 1 (ref)
0·73 (0·43-1·23) 0·85 (0·54-1·35)
Adjusted IRR (95% CI) 2·02 (1·49-2·74) 1·99 (1·39-2·85) 0·72 (0·43-1·23) 0·80 (0·50-1·27)
IRR incidence rate ratio
ESM 12 Comparison of estimates from Poisson models and from generalized estimating equation models to accommodate clustering by consultant
Outcome modelled Main/subgroup Covariates Procedure Poisson regression Generalized estimating equation model
Immediate complications Full model, prolapse Adjusted Anterior colporrhaphy with mesh 0·78 (0·41-1·46) 0·78 (0·42-1·45)
Immediate complications Full model, prolapse Adjusted Vaginal mesh vault repair (mesh) 0·95 (0·39-2·31) 0·95 (0·40-2·28)
Immediate complications Full model, prolapse Adjusted Posterior colporrhaphy (non mesh) 0·74 (0·62-0·89) 0·74 (0·63-0·88)
Immediate complications Full model, prolapse Adjusted Posterior colporrhaphy with mesh 0·31 (0·10-0·98) 0·31 (0·10-0·97)
Immediate complications Full model, prolapse Adjusted Open sacrocolpopexy (abdominal mesh) 1·32 (0·96-1·82) 1·32 (0·97-1·81)
Immediate complications Full model, prolapse Adjusted Sacrospinous fixation of vagina (non mesh) 0·94 (0·74-1·19) 0·94 (0·75-1·18)
Immediate complications Full model, prolapse Adjusted Vaginal hysterectomy (non mesh) 1·24 (0·99-1·54) 1·24 (1·00-1·53)
Immediate complications Full model, incontinence Adjusted Suprapubic sling (non mesh) 0·75 ( 0·50- 1·13) 0·75 ( 0·50- 1·12)
Immediate complications Full model, incontinence Adjusted Retropubic mesh 0·44 ( 0·36- 0·55) 0·44 ( 0·36- 0·55)
Immediate complications Full model, incontinence Adjusted Transobturator mesh 0·31 ( 0·24- 0·40) 0·31 ( 0·25- 0·39)
Immediate complications Full model, incontinence Adjusted Unspecified mesh 0·84 ( 0·68- 1·02) 0·84 ( 0·69- 1·00)
Immediate complications Full model, incontinence Adjusted Urethral injection therapy (non mesh) 1·01 ( 0·74- 1·37) 1·01 ( 0·75- 1·36)
Immediate complications Anterior compartment prolapse model Adjusted Anterior colporrhaphy with mesh 0·93 ( 0·49- 1·79) 0·93 ( 0·49- 1·77)
Immediate complications Posterior compartment prolapse model Adjusted Posterior colporrhaphy with mesh 0·49 (0·15-1·58) 0·49 (0·15-1·59)
Immediate complications Retropubic vs transobturator model Adjusted Transobturator mesh 0·71 (0·56-0·90) 0·71 (0·56-0·90)
Immediate complications Vaginal vault prolapse model Adjusted Vaginal mesh vault repair (mesh) 1·14 ( 0·46- 2·84) 1·10 ( 0·42- 2·87)
Immediate complications Vaginal vault prolapse model Adjusted Open sacrocolpopexy (abdominal mesh) 1·70 ( 0·89- 3·27) 1·72 ( 0·95- 3·13)
Later complication Full model, prolapse Adjusted Anterior colporrhaphy with mesh 3·18 (2·54-3·99) 3·18 (2·28-4·44)
Later complication Full model, prolapse Adjusted Vaginal mesh vault repair (mesh) 2·22 (1·51-3·27) 2·22 (1·27-3·89)
Later complication Full model, prolapse Adjusted Posterior colporrhaphy (non mesh) 1·15 (1·03-1·27) 1·15 (0·98-1·34)
Later complication Full model, prolapse Adjusted Posterior colporrhaphy with mesh 3·23 (2·52-4·13) 3·23 (2·25-4·63)
Later complication Full model, prolapse Adjusted Open sacrocolpopexy (abdominal mesh) 1·86 (1·53-2·26) 1·86 (1·39-2·49)
Later complication Full model, prolapse Adjusted Sacrospinous fixation of vagina (non mesh) 1·79 (1·55-2·07) 1·79 (1·46-2·20)
Later complication Full model, prolapse Adjusted Vaginal hysterectomy (non mesh) 1·09 (0·93-1·27) 1·09 (0·87-1·36)
Later complication Full model, incontinence Adjusted Suprapubic sling (non mesh) 1·54 (1·25-1·91) 1·54 (1·15-2·07)
Later complication Full model, incontinence Adjusted Retropubic mesh 1·12 (0·98-1·27) 1·12 (0·93-1·35)
Later complication Full model, incontinence Adjusted Transobturator mesh 1·02 (0·89-1·16) 1·02 (0·81-1·28)
Later complication Full model, incontinence Adjusted Unspecified mesh 1·03 (0·91-1·18) 1·03 (0·85-1·26)
Later complication Full model, incontinence Adjusted Urethral injection therapy (non mesh) 2·43 (2·07-2·86) 2·43 (1·77-3·33)
Later complication Anterior compartment prolapse model Adjusted Anterior colporrhaphy with mesh 3·15 (2·46-4·04) 3·05 (1·93-4·83)
Later complication Posterior compartment prolapse model Adjusted Posterior colporrhaphy with mesh 2·76 (2·11-3·61) 2·76 (1·85-4·12)
Later complication Retropubic vs transobturator model Adjusted Transobturator mesh 0·90 (0·81-1·01) 0·90 (0·75-1·09)
Later complication Vaginal vault prolapse model Adjusted Vaginal mesh vault repair (mesh) 1·23 (0·82-1·86) 1·24 (0·68-2·26)
Later complication Vaginal vault prolapse model Adjusted Open sacrocolpopexy (abdominal mesh) 0·88 (0·54-1·44) 0·88 (0·50-1·54)
Further prolapse surgery Full model, prolapse Adjusted Anterior colporrhaphy with mesh 1·62 (1·26-2·09) 1·63 (1·23-2·14)
Further prolapse surgery Full model, prolapse Adjusted Vaginal mesh vault repair (mesh) 1·24 (0·80-1·91) 1·24 (0·79-1·96)
Further prolapse surgery Full model, prolapse Adjusted Posterior colporrhaphy (non mesh) 0·73 (0·66-0·81) 0·73 (0·65-0·82)
Further prolapse surgery Full model, prolapse Adjusted Posterior colporrhaphy with mesh 1·19 (0·86-1·65) 1·19 (0·78-1·82)
Further prolapse surgery Full model, prolapse Adjusted Open sacrocolpopexy (abdominal mesh) 1·93 (1·64-2·28) 1·93 (1·61-2·32)
Further prolapse surgery Full model, prolapse Adjusted Sacrospinous fixation of vagina (non mesh) 1·55 (1·36-1·76) 1·55 (1·35-1·77)
Further prolapse surgery Full model, prolapse Adjusted Vaginal hysterectomy (non mesh) 0·90 (0·78-1·03) 0·89 (0·77-1·04)
Further prolapse surgery Full model, incontinence Adjusted Suprapubic sling (non mesh) 0·68 (0·44-1·04) 0·68 (0·41-1·12)
Further prolapse surgery Full model, incontinence Adjusted Retropubic mesh 0·30 (0·24-0·39) 0·30 (0·23-0·40)
Further prolapse surgery Full model, incontinence Adjusted Transobturator mesh 0·26 (0·20-0·34) 0·26 (0·20-0·35)
Further prolapse surgery Full model, incontinence Adjusted Unspecified mesh 0·37 (0·29-0·48) 0·37 (0·28-0·49)
Further prolapse surgery Full model, incontinence Adjusted Urethral injection therapy (non mesh) 0·20 (0·11-0·38) 0·20 (0·10-0·40)
Further prolapse surgery Anterior compartment prolapse model Adjusted Anterior colporrhaphy with mesh 1·69 (1·29-2·20) 1·69 (1·27-2·26)
Further prolapse surgery Posterior compartment prolapse model Adjusted Posterior colporrhaphy with mesh 1·70 (1·20-2·42) 1·70 (1·07-2·69)
Further prolapse surgery Retropubic vs transobturator model Adjusted Transobturator mesh 0·86 (0·66-1·14) 0·87 (0·64-1·16)
Further prolapse surgery Vaginal vault prolapse model Adjusted Vaginal mesh vault repair (mesh) 0·83 (0·53-1·31) 0·83 (0·53-1·33)
Further prolapse surgery Vaginal vault prolapse model Adjusted Open sacrocolpopexy (abdominal mesh) 0·77 (0·50-1·18) 0·77 (0·48-1·23)
Further incontience surgery Full model, prolapse Adjusted Anterior colporrhaphy with mesh 2·91 (1·95-4·34) 2·91 (1·92-4·40)
Further incontience surgery Full model, prolapse Adjusted Vaginal mesh vault repair (mesh) 1·30 (0·53-3·18) 1·30 (0·54-3·14)
Further incontience surgery Full model, prolapse Adjusted Posterior colporrhaphy (non mesh) 0·85 (0·69-1·04) 0·85 (0·68-1·06)
Further incontience surgery Full model, prolapse Adjusted Posterior colporrhaphy with mesh 1·21 (0·62-2·36) 1·20 (0·58-2·52)
Further incontience surgery Full model, prolapse Adjusted Open sacrocolpopexy (abdominal mesh) 1·70 (1·18-2·47) 1·70 (1·15-2·52)
Further incontience surgery Full model, prolapse Adjusted Sacrospinous fixation of vagina (non mesh) 0·87 (0·62-1·23) 0·87 (0·60-1·27)
Further incontience surgery Full model, prolapse Adjusted Vaginal hysterectomy (non mesh) 0·77 (0·56-1·05) 0·77 (0·55-1·07)
Further incontience surgery Full model, incontinence Adjusted Suprapubic sling (non mesh) 2·39 (1·79-3·20) 2·39 (1·70-3·37)
Further incontience surgery Full model, incontinence Adjusted Retropubic mesh 0·90 (0·73-1·11) 0·90 (0·71-1·15)
Further incontience surgery Full model, incontinence Adjusted Transobturator mesh 1·06 (0·86-1·30) 1·06 (0·83-1·34)
Further incontience surgery Full model, incontinence Adjusted Unspecified mesh 1·26 (1·03-1·54) 1·26 (0·99-1·59)
Further incontience surgery Full model, incontinence Adjusted Urethral injection therapy (non mesh) 7·15 (5·83-8·76) 7·15 (5·64-9·06)
Further incontience surgery Anterior compartment prolapse model Adjusted Anterior colporrhaphy with mesh 3·20 (2·06-4·96) 3·19 (1·98-5·13)
Further incontience surgery Posterior compartment prolapse model Adjusted Posterior colporrhaphy with mesh 1·40 (0·68-2·86) 1·40 (0·64-3·07)
Further incontience surgery Retropubic vs transobturator model Adjusted Transobturator mesh 1·16 (0·97-1·38) 1·16 (0·95-1·42)
Further incontience surgery Vaginal vault prolapse model Adjusted Vaginal mesh vault repair (mesh) 1·46 (0·55-3·85) 1·46 (0·57-3·74)
Further incontience surgery Vaginal vault prolapse model Adjusted Open sacrocolpopexy (abdominal mesh) 0·86 (0·26-2·84) 0·85 (0·17-4·33)
ESM 13 Adverse events following first single incontinence procedures in Scotland, 2006/07-2015/16 with 15 year look back to define first procedures
Open colposuspension
(non mesh)
Urethral injection therapy
(non mesh)
Suprapubic sling
(non mesh) Retropubic mesh Transobturator mesh
Number of patients 134 365 151 4528 4747
Years 2006/07-2015/16 2006/07-2015/16 2006/07-2015/16 2006/07-2015/16 2006/07-2015/16
Follow-up in months, median (interquartile range) 40·4 (15·2-60·9) 52·6 (28·5-60·9) 60·9 (14·5-60·9) 60·9 (43·6-60·9) 60·9 (48·5-60·9)
[A] Immediate postoperative complications
Patients with a complication, % (n) 6·7 (9) 7·1 (26) 5·3 (8) 3·7 (166) 2·5 (118)
Unadjusted RR (95% CI) 1 (ref)
1·06 ( 0·50- 2·26) 0·79 ( 0·30- 2·04) 0·54 ( 0·28- 1·06) 0·37 ( 0·19- 0·74)
Adjusted RR (95% CI) 1·01 (0·47-2·16) 0·77 (0·30-2·00) 0·58 (0·29-1·15) 0·41 (0·21-0·83)
[B] Late postoperative complication admissions
Patients with 1 or more admission 16 46 28 441 403
Total number of admissions within 5 years 33 107 44 669 683
Total person-years of follow-up 415 1314 512 19163 20887
Crude incidence rate per 1,000 person-years 79·5 81·5 85·9 34·9 32·7
Unadjusted IRR (95% CI) 1 (ref)
1·03 (0·69-1·51) 1·08 (0·69-1·70) 0·44 (0·31-0·62) 0·41 (0·29-0·59)
Adjusted IRR (95% CI) 0·97 (0·66-1·44) 1·02 (0·65-1·60) 0·50 (0·35-0·72) 0·46 (0·33-0·66)
[C] Further incontinence surgery admissions
Patients with 1 or more admission 6 91 13 193 248
Total number of admissions within 5 years 11 133 16 220 289
Total person-years of follow-up 415 1314 512 19163 20887
Crude incidence rate per 1,000 person-years 26·5 101·3 31·2 11·5 13·8
Unadjusted IRR (95% CI) 1 (ref)
3·82 (2·07-7·07) 1·18 (0·55-2·54) 0·43 (0·24-0·80) 0·52 (0·29-0·95)
Adjusted IRR (95% CI) 3·96 (2·14-7·35) 1·12 (0·52-2·42) 0·47 (0·26-0·87) 0·56 (0·31-1·04)
[D] Further prolapse surgery admissions
Patients with 1 or more admission 6 5 0 93 93
Total number of admissions within 5 years 7 6 0 104 97
Total person-years of follow-up 415 1314 512 19163 20887
Crude incidence rate per 1,000 person-years 16·9 4·6 0·0 5·4 4·6
Unadjusted IRR (95% CI) 1 (ref)
0·27 (0·09-0·81) - 0·32 (0·15-0·69) 0·28 (0·13-0·59)
Adjusted IRR (95% CI) 0·26 (0·09-0·77) - 0·23 (0·10-0·50) 0·19 (0·09-0·43)
Crude incidence rate per 1000 person-years = [total number of admissions within 5 years/total person-years of follow-up]*1000 RR relative risk; IRR incidence rate ratio
ESM 14 Direct comparison of adverse events following specific mesh first single incontinence procedures, Scotland 2006/07-2015/16 with 15 year look back to define first procedures
Retropubic mesh Transobturator mesh
Number of patients 4523 4698
Years 2006/07-2015/16 2006/07-2015/16
[A] Immediate postoperative complications
Unadjusted RR (95% CI) 1 (ref)
0·69 (0·54-0·87)
Adjusted RR (95% CI) 0·72 (0·56-0·91)
[B] Late postoperative complication admissions
Unadjusted IRR (95% CI) 1 (ref)
0·94 (0·84-1·05)
Adjusted IRR (95% CI) 0·91 (0·82-1·02)
[C] Further incontinence surgery admissions
Unadjusted IRR (95% CI) 1 (ref)
1·20 (1·01-1·43)
Adjusted IRR (95% CI) 1·18 (0·99-1·41)
[D] Further prolapse surgery admissions
Unadjusted IRR (95% CI) 1 (ref)
0·85 (0·65-1·13)
Adjusted IRR (95% CI) 0·84 (0·64-1·12)
RR rate ratio; IRR incidence rate ratio· Number of patients undergoing each procedure may be lower than that seen in ESM 12 as patients with missing data were excluded from the regression models.
ESM 15 Adverse events following first single prolapse procedures in Scotland, 2006/07-2015/16 with 15 year look back to define first procedures
Anterior colporrhaphy
(non mesh)
Anterior colporrhaphy with mesh
Posterior colporrhaphy
(non mesh)
Posterior colporrhaphy with mesh
Sacrospinous fixation of vagina
(non mesh)
Vaginal mesh vault repair
(mesh)
Open sacrocolpopexy
(abdominal mesh)
Vaginal hysterectomy
(non mesh)
Number of patients 4119 238 3138 178 1703 98 128 982
Years 2006/07-2015/16
2007/08-2015/16
2006/07-2015/16
2007/08-2015/16
2006/07-2015/16
2006/07-2015/16
2006/07-2015/16
2006/07-2015/16
Follow-up in months, median (interquartile range) 60·9
(35-60·9)
60·9
(50·5-60·9)
58·3
(33·1-60·9)
59
(50·5-60·9)
36
(20·3-60·9)
60·9
(60·9-60·9)
59·2
(40·1-60·9)
60·9
(42·5-60·9)
[A] Immediate postoperative complications
Patients with a complication, % (n) 3·7 (153) 2·9 (7) 3·0 (94) 0·6 (1) 4·4 (75) 3·1 (3) 8·6 (11) 5·5 (54)
Unadjusted RR (95% CI) 1 (Ref)
0·79 (0·37-1·68)
0·81 (0·63-1·05)
0·15 (0·02-1·07)
1·18 (0·89-1·55)
0·82 (0·26-2·57)
2·30 (1·25-4·24)
1·47 (1·08-2·01)
Adjusted RR (95% CI) 1 (Ref)
0·78 (0·36-1·66)
0·84 (0·65-1·09)
0·15 (0·02-1·08)
1·13 (0·85-1·49)
0·77 (0·24-2·43)
2·19 (1·18-4·06)
1·55 (1·13-2·12)
[B] Late postoperative complication admissions
Patients with 1 or more admission 258 44 234 33 153 15 12 82
Total number of admissions within 5 years 368 74 319 58 203 23 15 125
Total person-years of follow-up 16032 1072 11917 794 5176 457 505 4013
Crude incidence rate per 1,000 person-years 23·0 69·0 26·8 73·0 39·2 50·3 29·7 31·1
Unadjusted IRR (95% CI) 1 (Ref)
2·99 (2·33-3·83)
1·17 (1·00-1·36)
3·16 (2·39-4·17)
1·69 (1·42-2·01)
2·18 (1·43-3·32)
1·28 (0·77-2·15)
1·35 (1·10-1·65)
Adjusted IRR (95% CI) 1 (Ref)
3·19 (2·47-4·11)
1·11 (0·95-1·29)
2·94 (2·22-3·90)
1·75 (1·48-2·09)
2·02 (1·32-3·09)
1·44 (0·85-2·41)
1·32 (1·08-1·63)
[C] Further incontinence surgery admissions
Patients with 1 or more admission 95 22 70 6 27 5 1 19
Total number of admissions within 5 years 103 24 77 7 30 5 1 19
Total person-years of follow-up 16032 1072 11917 794 5176 457 505 4013
Crude incidence rate per 1,000 person-years 6·4 22·4 6·5 8·8 5·8 10·9 2·0 4·7
Unadjusted IRR (95% CI) 1 (Ref)
3·46 (2·22-5·39)
1·00 (0·74-1·34)
1·36 (0·63-2·93)
0·90 (0·60-1·35)
1·69 (0·69-4·15)
0·31 (0·04-2·18)
0·73 (0·45-1·19)
Adjusted IRR (95% CI) 1 (Ref)
3·15 (2·00-4·94)
0·93 (0·69-1·26)
1·22 (0·56-2·63)
0·95 (0·63-1·43)
1·55 (0·62-3·84)
0·35 (0·05-2·48)
0·71 (0·44-1·17)
[D] Further prolapse surgery admissions
Patients with 1 or more admission 415 42 232 21 235 13 16 114
Total number of admissions within 5 years 478 53 257 28 259 16 20 132
Total person-years of follow-up 16032 1072 11917 794 5176 457 505 4013
Crude incidence rate per 1,000 person-years 29·8 49·4 21·6 35·3 50·0 35·0 39·6 32·9
Unadjusted IRR (95% CI) 1 (Ref)
1·65 (1·24-2·20)
0·73 (0·63-0·85)
1·18 (0·81-1·73)
1·68 (1·44-1·95)
1·17 (0·71-1·93)
1·32 (0·85-2·07)
1·10 (0·91-1·34)
Adjusted IRR (95% CI) 1 (Ref)
1·61 (1·21-2·14)
0·69 (0·59-0·80)
1·10 (0·75-1·62)
1·73 (1·48-2·02)
1·13 (0·68-1·87)
1·39 (0·89-2·18)
1·05 (0·87-1·28)
Crude incidence rate per 1000 person-years = [total number of admissions within 5 years/total person-years of follow-up]*1000 RR relative risk; IRR incidence rate ratio
ESM 16 Direct comparison of adverse events following specific mesh and non mesh first single procedures for prolapse, by anatomical compartment, Scotland 2006/07-2015/16 with 15 year look back to define first procedures
Anterior compartment prolapse Posterior compartment prolapse Vaginal vault prolapse
Anterior colporrhaphy
(non mesh)
Anterior colporrhaphy with mesh
Posterior colporrhaphy
(non mesh)
Posterior colporrhaphy with mesh
Sacrospinous fixation of vagina
(non mesh)
Vaginal mesh vault repair
(mesh)
Open sacrocolpopexy
(abdominal mesh)
Number of patients 3708 238 2857 178 1700 98 128
Years 2007/08-2015/16 2007/08-2015/16 2007/08-2015/16 2007/08-2015/16 2006/07-2015/16 2006/07-2015/16 2006/07-2015/16
[A] Immediate postoperative complications
Unadjusted IRR (95% CI) 1 (ref)
0·78 (0·36-1·66) 1 (ref)
0·19 (0·03-1·39) 1 (ref)
0·69 ( 0·22- 2·20) 1·95 ( 1·03- 3·67)
Adjusted IRR (95% CI) 0·76 ( 0·35- 1·64) 0·20 (0·03-1·43) 0·70 ( 0·22- 2·26) 1·99 ( 1·02- 3·87)
B] Late postoperative complication admissions
Unadjusted IRR (95% CI) 1 (ref)
2·95 (2·29-3·79) 1 (ref)
2·73 (2·06-3·63) 1 (ref)
1·29 (0·84-1·98) 0·76 (0·45-1·28)
Adjusted IRR (95% CI) 3·32 (2·54-4·33) 2·75 (2·05-3·69) 1·06 (0·68-1·66) 0·87 (0·51-1·49)
[C] Further incontinence surgery admissions
Unadjusted IRR (95% CI) 1 (ref)
3·45 (2·20-5·42) 1 (ref)
1·43 (0·66-3·12) 1 (ref)
1·89 (0·73-4·86) 0·34 (0·05-2·50)
Adjusted IRR (95% CI) 3·20 (2·01-5·12) 1·35 (0·61-3·01) 1·58 (0·58-4·27) 0·37 (0·05-2·77)
[D] Further prolapse surgery admissions
Unadjusted IRR (95% CI) 1 (ref)
1·69 (1·27-2·25) 1 (ref)
1·61 (1·09-2·39) 1 (ref)
0·70 (0·42-1·16) 0·79 (0·50-1·24)
Adjusted IRR (95% CI) 1·60 (1·19-2·14) 1·64 (1·10-2·46) 0·65 (0·39-1·09) 0·74 (0·46-1·18)
RR relative risk; IRR incidence rate ratio. Number of patients undergoing each procedure may be lower than that seen in ESM 14 as patients with missing data were excluded from the regression models.