Questionnaire-based survey on obstetricians and gynaecologists' attitudes towards the surgical management of urinary incontinence in women during their childbearing years

Abstract

Objective: To determine the appropriate surgical management of incontinence in women who desire to maintain their childbearing capacity.

Design: Questionnaire-based survey.

Method: A postal questionnaire was sent to 251 (every fourth) consultant obstetricians and gynaecologists in the UK practising in both district general hospitals (n=156) and teaching hospitals (n=95).

Main outcome measures: Clinical consensus in the management of incontinence in women who are interested in childbearing.

Results: One hundred and thirty two (53%) consultants responded of which 22 (17%) were not involved in managing this group of women and were therefore excluded from analysis. Thirty-nine (36%) of the replies were from teaching hospital, 71 (65%) were from district general hospitals. Eighty-six (78%) consultants are prepared to perform a continence procedure on women who had not completed their families. One hundred (91%) would offer caesarean section to those continent pregnant women following their continence surgery. (Fisher's exact test' P=0.038). Interestingly, 67 (60.9%) of respondents still perform caesarean section to the pregnant women even if they are incontinent.

Conclusions: The majority of UK consultants would perform a continence procedure in women who wish to maintain their childbearing capacity. Colposuspension is the favoured surgical procedure. If women are continent following surgery, most prefer them to be delivered by caesarean section.