E-Posters-Management Practices in the Initial Assessment of Patients with Urogynecological Pathology

Management Practices in the Initial Assessment of Patients with Urogynecological Pathology - Edwin Guzman Diaz

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In a study conducted in February 2019, 30 gynecologists were evaluated regarding their management practices in patients with urogynecological pathology. The study found that 60% of the participants were female, with an average age of 50.27. 70% of the gynecologists graduated before the year 2000, which is when the management of urinary incontinence with suburethral sling takes place. 27% of the participants did not receive training in urogynecology, while 67% had a rotation in the area. <br /><br />Regarding hysterectomy in benign pathology, 40% of the gynecologists reported that the best way to perform it is vaginally. Additionally, 83% stated that they always check for hidden incontinence before performing a hysterectomy. When it comes to the studies requested to rule out urinary incontinence, 53% of the gynecologists do not request any, while 23% request urodynamic studies. For overactive bladder, 40% initiate conjugated estrogens and behavioral therapy, and 23% initiate antimuscarinics.<br /><br />The researchers found a clear heterogeneity in decision-making among the participants, except when it came to hidden incontinence, which was consistently checked when evaluating patients with advanced prolapse. There was no correlation found between decision-making and the gynecology training period, despite the introduction and expansion of the mid urethral sling at the beginning of the millennium.<br /><br />The study suggests the need for strengthening continuing education processes to ensure adherence to clinical practice guidelines in urogynecological pathology. It also emphasizes the importance of consolidating highly complex centers that can train gynecologists to become experts in pelvic floor issues. However, additional research and multidisciplinary teams would be necessary to develop updated clinical guidelines for a comprehensive approach to urogynecological problems.

Keywords

urogynecological pathology

urinary incontinence

suburethral sling

hysterectomy

hidden incontinence

urodynamic studies

overactive bladder

conjugated estrogens

behavioral therapy

clinical practice guidelines