Our aim was to evaluate medium-term patient-reported health and quality-of-life after midurethral sling (MUS) insertion and to compare outcomes between retropubic and obturator approaches using data from the French VIGI-MESH registry.
In the prospective cohort linked to the registry, 1789 participants who had undergone midurethral sling insertion responded to a health questionnaire that assessed impression of improvement, self-rated health, and quality of life. Self-rated health in our sample was compared to surveys in the French population. A multivariate analysis including an inverse probability of treatment weighting approach was used to balance baseline differences.
1230 participants received a retropubic sling and 559 received an obturator sling placed by 139 surgeons in 27 French centers. Median follow-up was 34 months. Overall, 78.6% of women reported that they were "much better" or "very much better", and 69.6% reported "good" or "very good" health (13.5% higher than observed in the general population of the same age). The mean quality of life scale was 76.0/100 (3.8 points higher than observed in the general population of the same age). We were unable to demonstrate a difference in patient-reported outcomes between the retropubic and obturator approaches. After adjustment, serious MUS complications were associated with poorer improvement but not with poorer global self-rated health.
In the medium term following MUS insertion, women participating in the VIGI-MESH registry tended to report good self-rated health and quality-of-life. Patient-reported outcomes did not significantly differ between retropubic and obturator approaches.
The French journal of urology. 2026 Jul 01 [Epub ahead of print]
Xavier Fritel, Léa Mauny, Camille Armengaud, Sandrine Campagne-Loiseau, Sandra Curinier, Laure Panel, Laurent Wagner, Xavier Deffieux, Michel Cosson, Christian Saussine, Renaud de Tayrac, Brigitte Fatton, Grégoire Capon, Emmanuel Chartier-Kastler, Philippe Ferry, Xavier Gamé, Jean-François Hermieu, Sophie Harter, Tristan Gauthier, Géry Lamblin, Emilie Lecornet, Jean-Philippe Lucot, Marie-Aimée Perrouin-Verbe, Rajeev Ramanah, Adrien Vidart, Lucie Merlet, Hocine Drioueche, Arnaud Fauconnier
Faculté de Santé, Université de Poitiers, Poitiers, France; INSERM CIC 1402, Service de Gynécologie-Obstétrique et Médecine de la Reproduction, CHU de Poitiers, Poitiers, France. Electronic address: ., Service de Gynécologie-Obstétrique, Centre Hospitalier de Poissy-Saint-Germain-en-Laye, Poissy, France., Service de Gynécologie-Obstétrique, CHU Estaing, Clermont-Ferrand, France., Service de Gynécologie, Clinique Beau-Soleil, Montpellier, France., Service d'Urologie, CHRU Carémeau, Nîmes, France., Service de Gynécologie-Obstétrique, Hôpital Antoine-Béclère-APHP, Pôle FAME, GHU Paris-Saclay, Clamart, France., Service de Gynécologie, Université de Lille, CHU de Lille, Lille, France., Service d'Urologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France., Service de Gynécologie-Obstétrique, CHRU Carémeau, Nîmes, France., Service d'Urologie, CHU Pellegrin, Bordeaux, France., Service d'Urologie, La Pitié-Salpêtrière AP-HP, Paris, France., Service de Gynécologie-Obstétrique, GHT La Rochelle-Ré-Aunis, La Rochelle, France., Département d'Urologie, Transplantation Rénale et Andrologie, CHU Rangueil, Université de Toulouse, Toulouse, France., Service d'Urologie, Hôpital Bichat AP-HP, Paris, France., Service de Gynécologie-Obstétrique, CHU de Nancy, Nancy, France., Service de Gynécologie-Obstétrique, CHU Dupuytren, Limoges, France., Service de Gynécologie-Obstétrique, Centre de Périnéologie, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon, Bron, France., Service d'Urologie, Polyclinique de Hénin-Beaumont, Hénin-Beaumont, France., Service de Gynécologie-Obstétrique, Hôpital Saint-Vincent-de-Paul, Groupe des Hôpitaux de l'Institut Catholique de Lille, Lille, France., Service d'Urologie, CHU de Nantes, Nantes, France., Service de Gynécologie-Obstétrique, CHU de Besançon, Université Marie & Louis Pasteur, Besançon, France., Service d'Urologie, Hôpital Foch, Suresnes, France., INSERM CIC 1402, Service de Gynécologie-Obstétrique et Médecine de la Reproduction, CHU de Poitiers, Poitiers, France., Plateforme de recherche clinique, Centre Hospitalier de Poissy-Saint-Germain-en-Laye, Poissy, France., Service de Gynécologie-Obstétrique, Centre Hospitalier de Poissy-Saint-Germain-en-Laye, Poissy, France; Université Paris-Saclay (UVSQ), Unité de recherche 7285 Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Montigny-le-Bretonneux, France.