Analysis of British Columbia practice patterns in the management of female stress urinary incontinence with emphasis on mesh use

Authors

  • Lauren Eggenberger University of British Columbia
  • Lauren Walgren University of British Columbia
  • Sara Houlihan University of British Columbia
  • Alexandra Bascom University of British Columbia
  • Katherine Anderson University of British Columbia
  • Kathleen A. Martin Ginis University of British Columbia
  • Jennifer A. Locke University of British Columbia Department of Urologic Sciences

DOI:

https://doi.org/10.5489/cuaj.8536

Keywords:

stress urinary incontinence, mesh, transvaginal tape, pubovaginal sling

Abstract

INTRODUCTION: Female stress urinary incontinence (SUI) is common and has a profound impact on quality of life. Suburethral slings are the most common treatment for SUI in this population. These can be placed with synthetic mesh or autologous fascia. Mesh-related complications after midurethral sling procedures are documented in the literature but the risk of complications and reoperation is lower than the use of transvaginal mesh for pelvic organ prolapse repair. In this study, we sought to evaluate local practice patterns of management of female SUI with specific emphasis on mesh use.

METHODS: A survey created by an expert panel was disseminated to respective provincial societies.

RESULTS: Sixty-eight percent of respondents offer midurethral slings in their practice but only 60.6% of these respondents would offer surgical removal of the sling if there were complications, such as mesh erosion or pain. A large portion (39.4%) of respondents are performing transobturator slings as compared to retropubic midurethral slings (36.3%) and only 8.5% have removed the leg component associated with the transobturator sling in their practice. Furthermore, compared to most respondents offering midurethral slings (64.8%), only a minority of surgeons offer alternatives: 23.9% of respondents offer periurethral bulking agent injections, 15.5% offer pubovaginal slings, and 12.7% offer retropubic urethropexies.

CONCLUSIONS: Our study supports that surgeons should continue to review surgical risks and alternative treatment options as part of the surgical consent process. As such, surgeons should be able to offer a variety of surgical approaches to manage female SUI.

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Author Biography

Jennifer A. Locke, University of British Columbia Department of Urologic Sciences

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Published

2024-01-30

How to Cite

Eggenberger, L. ., Walgren, L. ., Houlihan, S. ., Bascom, A. ., Anderson, K. ., Ginis, K. A. M. ., & Locke, J. A. (2024). Analysis of British Columbia practice patterns in the management of female stress urinary incontinence with emphasis on mesh use. Canadian Urological Association Journal, 18(5), E152–6. https://doi.org/10.5489/cuaj.8536

Issue

Vol. 18 No. 5 (2024): CUAJ May

Section

Original Research

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