E-Posters-A Survey of Practice Patterns of Combination Anti-incontinence and Prolapse Repair Procedures Amongst Female Pelvic Medicine and Reconstructive Surgery Providers

A Survey of Practice Patterns of Combination Anti-incontinence and Prolapse Repair Procedures Amongst Female Pelvic Medicine and Reconstructive Surgery Providers - Joseph B Pincus, MD

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A survey was conducted to investigate practice patterns of combination anti-incontinence and prolapse repair procedures among female pelvic medicine and reconstructive surgery providers. The survey was distributed at the 2016 Pelvic Floor Disorders Week, and 64 surveys were returned that met the inclusion and exclusion criteria.<br /><br />The results showed that 53% of respondents never performed a prophylactic anti-incontinence procedure on a patient with no signs of stress urinary incontinence (SUI), while the remaining 47% would consider doing so based on patient characteristics, with the majority opting for a mid-urethral sling (MUS) as the chosen procedure.<br /><br />When performing concomitant anti-incontinence and prolapse repair procedures for preoperatively demonstrable occult SUI, 63% of respondents reported using a retropubic sling, 11% a trans-obturator sling, and 8% a single incision sling.<br /><br />The survey also found that 92% of providers performed the anti-incontinence procedure after the prolapse repair portion of the surgery, with 77% commenting that they did so for better outcomes and 33% choosing the procedure order based on their training.<br /><br />There were no significant differences in the timing of MUS placement based on academic vs. non-academic center, geographic practice location, or number of years in practice. However, respondents in their first 10 years after training were more likely to attribute their choice of MUS timing to their training, while those with 11 or more years in practice were more likely to believe that placing the MUS after the prolapse repair was more effective for treating occult SUI.<br /><br />Overall, the survey highlights the heterogeneity in practice patterns among female pelvic medicine and reconstructive surgery providers regarding combination anti-incontinence and prolapse repair procedures.

Keywords

survey

practice patterns

combination anti-incontinence

prolapse repair procedures

female pelvic medicine

stress urinary incontinence

mid-urethral sling

retropubic sling

trans-obturator sling

occult SUI