[Surgical treatment of female urinary incontinence].
BACKGROUND
During the last decade, minimal invasive procedures have been introduced for treatment of urinary incontinence (UI) in women leading to shorter hospitalisation and fewer complications. The aim of this study was to outline clinical practice and attitudes among Danish UI surgeons.


METHODS
Surgeons performing UI procedures were identified and mailed a questionnaire in 2007 concerning 2006. Questions included specialisation, number of procedures, type of surgery, complications and attitude towards learning surgery and maintaining a sufficient level of routine.


RESULTS
In total, 94 operating gynaecologists and urologists were identified, 63 responded (71%) of whom 49 (78%) performed UI surgery. UI surgeons were gynaecologists 43 (88%) of these 24 (49%) were urogynecologists (working more than 50% with urogynecology) and five (10%) urologists. Tension-free Vaginal Tape (TVT) was the preferred sling in 2006. A total of 20 (47%) UI surgeons used only TVT, seven (17%) only transobturator slings (TOS) and 15 (36%) both TVT and TOS. Only 11 (24%) performed > 25 TVT per year and 11 (27%) performed > 25 TOS per year. In all, UI surgeons had experience with ten different slings. This study did not allow for a quantitative assessment of complications. The attitude was that 10-25 operations are needed to learn the procedure, and that > 10 operations per year are needed to maintain a sufficient level of routine.


CONCLUSIONS
Practice and attitudes among urinary incontinence surgeons vary considerably and there is a lack of consensus. Many UI surgeons perform few operations with different techniques.
Gynaekologisk-Obstetrisk Afdeling, Herlev Hospital, Denmark. acea@glo.regionh.dk
Astrid Cecilie
AC
Ammendrup
Helle Christina
HC
Sørensen
Pia
P
Sander
Gunnar
G
Lose
D002983:Clinical Competence; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D053825:Suburethral Slings / Q000009:adverse effects; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000601:surgery*; D014550:Urinary Incontinence, Stress / Q000601:surgery; D013520:Urologic Surgical Procedures / Q000009:adverse effects / Q000379:methods*