Healthcare professional's choice for surgical management of stress urinary incontinence in a U.K. tertiary hospital.

Autor: Araklitis G; Department of Urogynaecology, King's College Hospital, London, UK. Electronic address: george.araklitis@nhs.net., Baines G; Department of Urogynaecology, King's College Hospital, London, UK., Da Silva AS; Department of Urogynaecology, King's College Hospital, London, UK., Rantell A; Department of Urogynaecology, King's College Hospital, London, UK., Robinson D; Department of Urogynaecology, King's College Hospital, London, UK., Cardozo L; Department of Urogynaecology, King's College Hospital, London, UK.
Jazyk: angličtina
Zdroj: European journal of obstetrics, gynecology, and reproductive biology [Eur J Obstet Gynecol Reprod Biol] 2021 Aug; Vol. 263, pp. 7-14. Date of Electronic Publication: 2021 May 24.
DOI: 10.1016/j.ejogrb.2021.05.039
Abstrakt: Objective: In July 2018, NHS England, introduced a pause on vaginal mesh, including the mid-urethral sling (MUS) for treatment of stress urinary incontinence (SUI). NICE guidelines recommend MUS as one of the surgical options for SUI. The aim of our study was to investigate healthcare professionals choices for surgical treatment of SUI, if conservative measures failed.
Study Design: The urogynaecology department at our tertiary level hospital devised a questionnaire using SurveyMonkey. This was distributed via email to 1058 healthcare professionals of different medical backgrounds. The surgical options were based on the NICE guideline and its patient decision making aid. We also used surgical information from the British society of Urogynaecology (BSUG) and British association of urological surgeons (BAUS).
Results: We received 214 responses of which 204 were complete. Twenty six percent of replies were from obstetricians and gynaecologists, 36 % had over 20 years experience and 79 % were female. Forty four percent had no previous knowledge of surgical options. Mid-urethral sling was the most popular choice based on description, success and specific complications. Urethral bulking agent was the only option that increased in popularity after describing complications. Twenty two percent would avoid surgery due to the risk of complications.
Conclusion: This is the first study evaluating healthcare professionals surgical choice for SUI. Despite negative media publicity and NHS pause on MUS, it was still the most popular choice before and after informing of specific complications. The urethral bulking agent was the only surgical treatment, which increased in popularity after considering complications.
Competing Interests: Declaration of Competing Interest The authors report no declarations of interest.
(Copyright © 2021 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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