title: Practice patterns in the treatment of female urinary incontinence: a postal and internet survey.
abstract: OBJECTIVE
  To survey American urologists to assess practice patterns in treating female incontinence. Advances in the treatment of female incontinence have changed the way urologists practice.
  
  
  METHODS
  Postal and e-mail surveys were sent to 2502 members of the American Urological Association.
  
  
  RESULTS
  From the postal group (n = 1000), 419 (42%) responses were obtained; from the e-mail group (n = 1502), 160 (11%) responses were obtained. For types I, II, and III stress urinary incontinence (SUI), 239 (44%) of 546, 388 (68%) of 570, and 512 (94%) of 547 urologists, respectively, recommended a sling procedure. For type I SUI, 75 (53%) of the 143 respondents in practice for less than 10 years recommended a sling procedure. The sling was recommended by 62 (35%) of the 176 respondents in practice for longer than 20 years (P <0.001). Most urologists (75%, 358 of 480) referred patients with significant vaginal prolapse to a gynecologist; however, urologists in full-time academic practice were more likely to offer surgical treatment (56%, 29 of 52). Most urologists recommended medical treatment for urge incontinence (94%, 461 of 491), and the medications most commonly selected were tolterodine (41%, 202 of 491), oxybutynin (26%, 129 of 491), and extended-release oxybutynin (25%, 125 of 491).
  
  
  CONCLUSIONS
  Overall, a sling procedure was the most commonly recommended surgical procedure for all types of SUI. Most urologists referred patients with significant vaginal prolapse to a gynecologist. For type I SUI, older urologists were more likely than younger urologists to perform needle bladder neck suspension.
authors.affiliation: Section of Urology, Department of Surgery, University of Chicago Pritzker School of Medicine, Chicago, Illinois, USA.
authors.forename: H L
authors.initials: HL
authors.lastname: Kim
authors.forename: G S
authors.initials: GS
authors.lastname: Gerber
authors.forename: R V
authors.initials: RV
authors.lastname: Patel
authors.forename: C M
authors.initials: CM
authors.lastname: Hollowell
authors.forename: G T
authors.initials: GT
authors.lastname: Bales
mesh_terms: D005260:Female; D019538:Health Care Surveys / Q000706:statistics & numerical data; D006801:Humans; D020407:Internet; D011177:Postal Service; D010818:Practice Patterns, Physicians'; D011364:Professional Practice; D014481:United States; D014550:Urinary Incontinence, Stress / Q000601:surgery / Q000628:therapy*; D014572:Urology; D014596:Uterine Prolapse / Q000601:surgery