Retrospective Review of Surgery for Urogynaecological Prolapse and Stress Urinary Incontinence Report

Date published: 27 November 2018

The Department of Health today published the experimental statistics “Retrospective review of surgery for urogynaecological prolapse and stress urinary incontinence using tape or mesh, Northern Ireland, April 2008 - March 2017.”

hospital activity statistics

The purpose of this publication is to report a retrospective review of Hospital Inpatient System (HIS) data pertaining to urogynaecological surgery for the treatment of pelvic organ prolapse (POP) and stress urinary incontinence (SUI) using vaginal mesh or tape, in comparison with non-mesh/tape procedures for the same indications.  A regional count for Northern Ireland of patients who have undergone an operation relating to the insertion, repair or removal of vaginal mesh or tape is provided.

Key Points

Number of patients who have undergone urogynaecological treatment procedures

  • Between 2008/09 and 2016/17, 8,449 patients had urogynaecological treatment procedures. Of these, 4,791 (56%) patients had procedures for stress urinary incontinence and 3,757 (44%) for urogynaecological prolapse. Please note that it is possible for the same woman to have both procedure types and during the study period this was true for 99 women.
  • The number of patients with reported urogynaecological procedures to treat stress urinary incontinence or urogynaecological prolapse reduced for all except one year from 1,222 patients in 2008/09 to 613 patients in 2016/17. This equates to an overall reduction of 50% between 2008/09 and 2016/17.

Number of patients who have undergone a tape/non-tape procedure for treatment of stress urinary incontinency

  • Between 2008/09 and 2016/17, 4,784 patients had a reported tape insertion procedure for stress urinary incontinence, of whom 10 patients had readmissions for a removal procedure occurring within 30 days of a confirmed insertion procedure.  This equates to an average removal rate of 2.2 per 1,000 patients.
  • For patients who had a removal procedure more than 30 days after their initial insertion, the highest rate of readmissions occurred in the reporting year following the insertion, with the exceptions of insertions in 2008/09 and 2011/12, which had the highest rate of readmission in the same year as the insertion.
  • Between 2008/09 and 2016/17, 13 patients had a reported non-tape procedure for stress urinary incontinence. There were no readmissions for a removal procedure following a confirmed insertion of this type during the study period.

Number of patients who have undergone a mesh/non-mesh procedure for treatment of urogynaecological prolapse

  • Between 2008/09 and 2016/17, 694 patients had a reported mesh insertion procedure for urogynaecological prolapse, reducing by 69% from 121 patients in 2008/09 to 38 in 2016/17. There were 9 reported readmissions for a removal procedure more than 30 days after the identified insertion procedure, and none within 30 days.
  • Between 2008/09 and 2016/17, 3,131 patients had a reported non-mesh procedure for urogynaecological prolapse, reducing by 43% from 441 in 2008/09 to 251 in 2016/17. During 2008/09 – 2017/18, there were no readmissions within 30 days for a removal procedure following a confirmed insertion of this type, and only 3 readmissions for removal more than 30 days after the insertion.

Notes to editors: 

  1. The report can be found on the Department’s website.
  2. Methodology:

    This review followed a similar methodology to that carried out in England by NHS Digital and therefore enabled a comparison of the surgery insertion and removal rates in NI with service delivery in England.  Whilst the NHS Digital methodology was followed closely where possible, due to differences in data collection between NI and England it has not been possible to match exactly their analysis, specifically in relation to outpatient appointments and comparison with an age-matched cohort outside of the urogynaecological study group. However, overall, the outcome of this review for Northern Ireland is very consistent with the NHS Digital review.  Although, pro rata, more insertions were carried out locally than in England, the rates of removal were broadly similar.

    The conclusions reached by the Policy Innovation and Research Unit (PIRU) in their commentary on the review in England are also applicable in the Northern Ireland context. The PIRU commentary notes that the findings are consistent with many studies in confirming that some women will experience adverse effects of mesh and tape implants to the extent that removal is necessary, however the scale of any problem cannot be accurately determined.
  3. About the data:

    The statistics in the report are Experimental Statistics. These are official statistics which are published in order to involve users and stakeholders in their development and as a means to build in quality at an early stage.

    In carrying out this analysis, it is recognised that the data are routinely collected administrative data, which are not collected to provide an accurate analysis of patient outcomes or the benefits or safety of any surgery.

    Inpatient and day case episode data for all specialties within the acute services programme of care is collated monthly from each hospital’s Patient Administration System and is recorded in the Hospital Inpatient System (HIS).  Each record within the HIS relates to an individual consultant episode and records details such as the date the patient was admitted, the diagnosis of the patient and any interventions/procedures the patient underwent. 
  4. Definitions:

    Finished Consultant Episode (FCE): A period of continuous admitted patient treatment under the care of a consultant.  An episode may be finished through death, discharge or transfer to the care of another consultant or hospital.  If the patient is transferred from one consultant to another, a new FCE commences.

    Procedure / Intervention: A procedure or series of procedures aimed at restoring or improving the health of a patient, as by correcting a malformation, removing diseased parts, implanting new parts, etc.  Defined by an OPCS code recorded in any of the procedure fields in the Hospital Inpatient System.
  5. This information was collated by Hospital Information Branch, DoH.  Further information is available from –

    Hospital Information Branch
    Information and Analysis Directorate
    Department of Health
    Annexe 2
    Castle Buildings
    Belfast BT4 3SQ

    Telephone: 028 9052 2914

  6. For media enquiries please contact the Department of Health Press Office team on 028 9052 0575 or email For out of hours please contact the Duty Press Officer on 028 9037 8110 and your call will be returned.

    Follow us on twitter @healthdpt

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