Survey on surgery for stress urinary incontinence in an era mid-urethral slings are being questioned
- PDF / 543,135 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 111 Downloads / 152 Views
REVIEW ARTICLE
Survey on surgery for stress urinary incontinence in an era mid-urethral slings are being questioned An-Sofie D’hulster 1 & Susanne Housmans 2 & Wilbert Spaans 3 & Frank Van der Aa 4,5 & Koen Slabbaert 6 & Alfred L. Milani 7 & Jan Deprest 2,4 Received: 25 June 2019 / Accepted: 23 September 2019 # The International Urogynecological Association 2019
Abstract Introduction Concerns about vaginal mesh have reduced the use of mid-urethral slings (MUS) in some countries. In view of their potential withdrawal in Belgium and The Netherlands, we polled urogynaecologists on their practice for treating stress urinary incontinence (SUI) and what their experience is with alternative procedures, and we asked them how their patients perceive the risk and success rates. Methods A survey among members of the pelvic floor special interest group of the Flemish Society for Obstetrics and Gynaecology, Belgian Association of Urology and Dutch Society of Obstetrics and Gynaecology. Results Their primary procedure of choice is the MUS (99%). Sixty-five per cent performs at least 25 MUS yearly; they report high success (90%; IQR [85–92]) and low adverse outcome rates. Physicians anticipate complications as reported in the literature: 5% (IQR [410]) overactive bladder, 5% (IQR [2–10]) voiding problems, 2% (IQR [15]) exposures, 2% (IQR [1–5]) dyspareunia and 1% (IQR [1–3]) chronic pain. Eighty-five per cent of physicians report their patients express fears about having a MUS though usually they cannot precisely tell why. Reportedly they tell their physicians of concerns about pain (54%), exposure (45%), dyspareunia (25%), voiding problems (15%) or overactive bladder (8%). Only half of respondents had ever performed a colposuspension. The majority of these were older and performed colposuspension via laparotomy. Only six (4%) had performed > 20 colposuspensions yearly. Conclusion Dutch and Belgian urogynaecologists estimate success and adverse effect rates of MUS in line with the literature. Their patients most cited worries were fear of chronic pain and exposure. Only half of respondents had ever performed a colposuspension. They were older and performed the procedure via laparotomy. Keywords Mid-urethral sling . Burch colposuspension . Stress urinary incontinence
Introduction Stress urinary incontinence (SUI) is the complaint of involuntary loss of urine through the urethra, synchronous with an
increase in intra-abdominal pressure. This can be due to urethral hypermobility and/or relative sphincter deficiency. SUI may be treated conservatively, pharmacologically or surgically.
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00192-019-04135-0) contains supplementary material, which is available to authorized users. * An-Sofie D’hulster [email protected] 1
Faculty of Medicine, Biomedical Sciences, KU Leuven, 3000 Leuven, Belgium
2
Department of Obstetrics and Gynaecology, University Hospitals Leuven, 3000 Leuven, Belgium
3
Department of Obstetrics and Gy
Data Loading...
