Logo image
Back
Sling Trocar Perforation Rates With and Without Concomitant Prolapse Surgery
Journal article   Peer reviewed

Sling Trocar Perforation Rates With and Without Concomitant Prolapse Surgery

Alexa Primavera, Katherine Albus, Dayun K. Lee, Yue Yin, Radhika Patnam and Jessica C. Sassani
Urogynecology, v 32(3), pp 265-271
01 Mar 2026
DOI: https://doi.org/10.1097/SPV.0000000000001792
PMID: 41627037

Abstract

Life Sciences & Biomedicine Obstetrics & Gynecology Science & Technology
Importance Midurethral slings are frequently placed during prolapse surgery. Objectives The objectives of this study were to compare retropubic midurethral sling (MUS) bladder trocar perforation rates among women undergoing MUS-only (soloMUS) surgery versus MUS with concomitant apical prolapse repair (popMUS). Study Design A retrospective cohort study of women aged 18-89 years who underwent MUS surgery between January 2018 and October 2024 was performed. Transobturator sling surgery and nonapical concomitant prolapse repairs were excluded. The primary outcome was bladder trocar perforation rates. Secondary outcomes included emergency department visits, reoperation rates, and admissions within 30 days of the procedure. ResultsA total of 816 MUS procedures met eligibility criteria, with 236 patients in the popMUS group and 580 in the soloMUS group. Age was lower (52 vs 65, P<0.001) and body mass index (BMI) was higher in the soloMUS group (30 vs 28, P=0.001). The primary outcome, the bladder trocar perforation rate, was higher in the popMUS group (11.0% vs 4.3%, P<0.001). Readmissions and emergency department visits were higher for the popMUS group, but reoperations were similar. When controlling for age, BMI, concomitant hysterectomy, concomitant sacrocolpopexy, surgeon, and menopause status, sacrocolpopexy and surgeon remained significant. Women undergoing sacrocolpopexy were significantly more likely to have bladder perforation compared with those undergoing nonsacrocolpopexy prolapse repairs (OR,2.47; 95% CI, 1.04-5.89, P=0.04). ConclusionsOverall, trocar perforations were higher in women undergoing concomitant apical prolapse repair, especially at the time of sacrocolpopexy. This may be due to differential tissue tension in the immediate postprolapse repair anatomy that differs from naturally supported anatomy. Further work is needed to identify perforation risks for concomitant surgical procedures and clinical sequelae.

Metrics

1 Record Views

Details

UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

Source: SDGs in the Output

InCites Highlights

Data related to this publication, from InCites Benchmarking & Analytics tool:

Collaboration types
Domestic collaboration
Web of Science research areas
Obstetrics & Gynecology
Logo image