Stress urinary incontinence (SUI) is a common condition, managed by both urologists and gynecologists. However, the treatment options and continence aids discussed with patients may vary substantially between urologists and gynecologists. This study aimed to:
•	Identify which treatment modalities and continence aids are discussed for various SUI scenarios.
•	Compare inter-specialty differences, especially in complex or recurrent cases.
•	Explore knowledge gaps and perceived barriers in patient counseling.

A digital survey was distributed nationally via Dutch professional gynecological and urological societies (NVOG and NVU). The questionnaire included items on clinical experience, care setting, use of continence aids and treatment options discussed for primary and recurrent SUI (mild/moderate vs. severe). Free-text responses explored perceived limitations in daily clinical practice. Descriptive and thematic analyses were performed.

Of 176 respondents (119 gynecologists, 57 urologists), most had over 10 years of clinical experience. Key findings:
•	Continence aids: Pessaries were more frequently discussed by gynecologists, whereas urologists more often addressed catheter use (32% vs. 11%).
•	Primary Mild/Moderate SUI – Modest Specialty Differences (Table 1):
While PFMT and mid-urethral slings were widely discussed by both groups, notable differences appeared: gynecologists discussed SIMS more frequently (47% vs. 18%), while urologists more often mentioned TOT and fascial slings.
•	Bulking agent trends: Non-absorbable bulking agents were more commonly discussed than absorbable types, suggesting either a preference or lack of familiarity with the latter.
•	Severe SUI – Recurrent Cases (Table 2):
In complex cases, variation increases significantly. Urologists more frequently discussed fascial slings (46% vs. 19%) and artificial urinary sphincters (39% vs. 12%). Conversely, gynecologists more often mentioned SIMS (25% vs. 4%).
•	Influence of setting and experience: University hospitals more often discussed advanced options like fascial slings and AUS. Clinicians with <5 years of experience addressed a broader range of surgical treatments in both subtypes of recurrent SUI .
•	Identified Barriers: Respondents reported a lack of familiarity with the full range of options, unclear referral structures, and the absence of decision-support tools.

Substantial variation exists in discussed treatment options for SUI, with increasing divergence in complex cases. This variation appears driven more by clinician-related factors and local structures than by clinical guidelines. There may be some bias in the results due to the relatively smaller group of urologists and the larger proportion of specialists with more than 10 years of experience in both groups.

To improve consistency and equity in SUI counseling, clinical guidelines should be updated to include structured diagnostic and treatment pathways, tailored per SUI subtype, with clear overviews of available treatment options and continence aids. In line with EAU recommendations and our national NVOG/NVU guideline, counseling should ensure that women are offered appropriate surgical options. Strengthening interdisciplinary collaboration and referral structures will help achieve this, ensuring patients receive timely, well-informed guidance regardless of care setting. Enhanced training and decision-support tools remain essential to reduce knowledge gaps and support guideline-based practice.