Hypothesis / aims of study
The midurethral sling (MUS) is the standard surgical treatment for female stress urinary incontinence (SUI). In response to concerns regarding MUS safety, its availability on the French market has been extended for three years. We conducted a national survey to assess healthcare professionals’ experience with alternative surgical techniques.
Study design, materials and methods
An online questionnaire comprising 38 items was distributed via three french professional societies (SIFUD-PP, SCGP, and AFU). It explored respondents’ characteristics and their experience with MUS, Burch colposuspension, autologous slings, and Bulkamid® injections.
Results
A total of 168 practitioners responded: 84.5% were urologists, 15.5% gynecologists, and 66% practiced in hospitals. Nearly 70% had over 10 years of experience, and 40% dedicated more than 50% of their activity to urogynecology.
The use of MUS remained common: 65.5% performed TVT, 60.7% TOT, and 70% performed more than 10 MUS procedures per year. Among respondents, 61% believed that safety concerns about MUS were justified but did not warrant market withdrawal. Many expressed interest in further training on colposuspension (44%), Bulkamid injections (44%), and autologous slings (54.8%).
Bulkamid® injections were used by 27.4% of respondents, while 51% had never performed the procedure. Among those who had, 19% reported performing at least 10 injections per year. 90% considered the procedure to be less effective but also less risky than MUS in the long term.
55% had never performed a Burch colposuspension. Of those who had, 70% were trained over 20 years ago, and 75% performed 1 to 5 procedures annually. 72% considered it less effective and 44% less risky than MUS over the long term.
72% had never performed an autologous sling procedure. Among those who had, 72% were trained over 20 years ago, and 75% performed 1 to 5 procedures annually. 67% felt the procedure was less effective and 42% less risky than MUS in the long term.
Interpretation of results