title: Symptomatic stress urinary incontinence not demonstrated clinically: survey of practice patterns.
abstract: The aim of this study was to survey obstetrician/gynecologists and urologists regarding management of women undergoing hysterectomy with complaints of stress urinary incontinence (SUI) not demonstrated clinically. A survey was distributed electronically to military healthcare system OB/GYN and urologist physicians. Overall descriptive data and responses analyzed according to respondent demographics and the presence or absence of pelvic organ prolapse are reported. Two-hundred forty-two responses were obtained (44% response rate). Without prolapse, only 32% would perform an anti-incontinence procedure, more often by urologists than OB/GYN physicians. With prolapse, more respondents would perform an anti-incontinence procedure (32% increasing to 59%, p < 0.001). A mid-urethral sling was the most common procedure that was offered. Trainee versus attending status and teaching versus non-teaching responsibilities did not affect responses. There is no consensus among military obstetricians/gynecologists and urologists regarding management of women otherwise undergoing pelvic surgery with subjective SUI. The presence of prolapse influences this decision.
authors.affiliation: Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Walter Reed Army Medical Center, Washington, DC, USA.
authors.forename: Thaddeus D
authors.initials: TD
authors.lastname: Mamienski
authors.forename: John R
authors.initials: JR
authors.lastname: Fischer
authors.forename: Alan
authors.initials: A
authors.lastname: Gehrich
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Zahn
mesh_terms: D003625:Data Collection; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000295:instrumentation / Q000379:methods; D006176:Gynecology; D006801:Humans; D008889:Military Personnel; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D053825:Suburethral Slings; D014550:Urinary Incontinence, Stress / Q000209:etiology / Q000601:surgery*; D014572:Urology; D014596:Uterine Prolapse / Q000150:complications / Q000601:surgery*; D000078329:Workforce
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