Surgical management of stress urinary incontinence: a questionnaire based survey

Abstract

Objectives: To determine the trends in the surgical management of urinary stress incontinence amongst members of the International Urogynaecology Association (IUGA).

Design: Postal Questionnaire Survey.

Methods: 530 members of the International Urogynaecology association were sent a postal questionnaire regarding their practice in the surgical management of urinary stress incontinence. We also collected data on the demographic profile of members and the preferred primary and secondary continence procedures.

Outcome: Consensus in the surgical management of urinary stress incontinence amongst members of the IUGA.

Results: Five hundred and thirty questionnaires were sent to IUGA members worldwide. Two hundred and seventeen questionnaires were received of which fifteen were from physiotherapists, so were excluded from our analysis. The overall response rate was 41%, and the useable response rate was 38%. Of the total results analysed (two hundred and two), one hundred and twelve (54%) were from teaching hospital, sixty-two (31%) were from district general hospitals and twenty-eight (14%) were from members in private practice. The preferred primary continence procedure was Tension Free Vaginal Tape (TVT) in one hundred and thirty four (68%) respondents. The preferred secondary continence procedure was colposuspension or Trans obturator tape in twenty-six respondents each (13%).

Conclusions: Almost all respondents (97.1%) were skilled at performing either TVT or colposuspension, which have been identified as the preferred methods of surgical management by the NICE (National Institute of Clinical Excellence, UK). Although colposuspension has been identified as the gold standard surgical procedure in the management of stress incontinence, 16% of respondents were not performing colposuspension. There appears to be little evidence base to the surgical techniques in the management of stress urinary continence.