Telemedicine follow-up is safe and efficacious for synthetic midurethral slings: a randomized, multi-institutional control trial

• Published in: International Urogynecology Journal Vol. 33; no. 4; pp. 1007 - 1015
• Main Authors: Giusto, Laura L., Derisavifard, Samir, Zahner, Patricia M., Rueb, Jessica J., Deyi, Luo, Jiayi, Li, Weilin, Fang, de Jesus Moreira, Raphael, Gomelsky, Alexander, Balzarro, Matteo, Goldman, Howard B.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-04-2022; Springer Nature B.V
• Subjects: Female; Follow-Up Studies; Gynecology; Humans; Male; Medicine; Medicine & Public Health; Original; Original Article; Patient satisfaction; Postoperative period; Prospective Studies; Suburethral Slings - adverse effects; Telemedicine; Treatment Outcome; Urinary Incontinence, Stress - etiology; Urinary Incontinence, Stress - surgery; Urology; Midurethral sling; Stress urinary incontinence; Patient satisfaction; Telemedicine; Postoperative care
• ISSN: 0937-3462; 1433-3023
• DOI: 10.1007/s00192-021-04767-1

Introduction and hypothesis
The objective was to assess whether telemedicine-based follow-up is equivalent to office-based follow-up in the early postoperative period after routine synthetic midurethral sling placement.
Methods
This is a prospective, international, multi-institutional, randomized controlled trial. Patients undergoing synthetic midurethral sling placement were randomized to 3-week postoperative telemedicine versus office-based follow-up. The primary outcome was the rate of unplanned events. Secondary outcomes included patient satisfaction, crossover from telemedicine to office-based follow-up, and compliance with 3- to 5-month office follow-up.
Results
We included 238 patients (telemedicine: 121 vs office: 117). No differences in demographics or medical comorbidities were noted between the study groups (
p
= 0.09–1.0). No differences were noted in unplanned events: hospital admission, emergency department visit, or unplanned office visit or call (14% vs 12.9%,
p
 = 0.85) or complications (9.9% vs 8.6%,
p
 = 0.82). Both groups were equally “very satisfied” with their surgical outcomes (71.1% vs 69%,
p
 = 0.2). Telemedicine patients were more compliant with 3- to 5-month office follow-up (90.1% vs 79.3%,
p
 = 0.04).
Conclusions
After synthetic midurethral sling placement, telemedicine follow-up is a safe patient communication option in the early postoperative period. Telemedicine patients reported no difference in satisfaction compared with office-based follow-up but had greater compliance with 3- to 5-month follow-up.