title: The surgical trends and time-frame comparison of primary surgery for stress urinary incontinence, 2006-2010 vs 1997-2005: a population-based nation-wide follow-up descriptive study.
abstract: OBJECTIVE
  The purpose of our study was to describe the surgical trends for female stress urinary incontinence (SUI) during 2006-2010, and a time-frame comparison with 1997-2005, based upon the National Health Insurance (NHI) claims data in Taiwan.
  
  
  METHODS
  Women who underwent various primary surgeries for SUI during 2006-2010 were identified, with a total of 15,099 inpatients. The variables included surgical types, patient age, surgeon age and gender, specialty, and hospital accreditation levels. Chi-squared tests and SAS version 9.3.1 were used for statistical analysis.
  
  
  RESULTS
  During the follow-up study, midurethral sling (MUS) application increased significantly from 53.09 % in 2006 to 78.74 % in 2010. It was associated concomitantly with a decrease in retropubic urethropexy (RPU) from 29.68 % to 12.99 %, and pubovaginal sling treatment (PVS) from 9.33 % to 3.46 %. MUS was most commonly used among all patients' and surgeons' age groups, and different accreditation hospital levels. MUS was more commonly used by gynecologists (71.38 %) than urologists (57.91 %); while PVS and periurethral injection were more commonly performed by urologists than gynecologists. Similar surgical trends were found during time-frame comparison, 2006-2010 vs 1997-2005. SUI surgeries increased in patients aged ≥60, surgeons aged ≥ 50, and in regional hospitals.
  
  
  CONCLUSIONS
  This follow-up study depicts the increase in popularity of MUS and offers evidence of surgical trends and a paradigm shift for female SUI surgery. More older women were willing to seek healthcare and undergo surgery. The surgical skills and knowledge spread from medical centers into regional hospitals. The time-frame shift may have a profound impact on patients, as well as the healthcare providers.
authors: Department of Obstetrics and Gynecology, Chi Mei Medical Center, Liouying, Tainan, Taiwan.
authors: Chia-Jen
authors: CJ
authors: Wu
authors: Yat-Ching
authors: YC
authors: Tong
authors: Sheng-Mou
authors: SM
authors: Hsiao
authors: Ching-Chung
authors: CC
authors: Liang
authors: So-Jung
authors: SJ
authors: Liang
authors: Shih-Feng
authors: SF
authors: Weng
authors: Ming-Ping
authors: MP
authors: Wu
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000706:statistics & numerical data / Q000639:trends*; D006801:Humans; D008875:Middle Aged; D009313:National Health Programs / Q000706:statistics & numerical data; D012189:Retrospective Studies; D053825:Suburethral Slings / Q000706:statistics & numerical data / Q000639:trends*; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D014550:Urinary Incontinence, Stress / Q000453:epidemiology / Q000601:surgery*