To compare the operative results of midurethral sling (MUS) surgeries for stress urinary incontinence (SUI) performed by residents under the guidance of an attending specialist in urogynecology, to those done by attendings.
Retrospective chart review DESIGN CLASSIFICATION: Canadian Task Force classification II-2 SETTING: University hospital PATIENTS: A retrospective analysis of all MUS's performed between January 2009 to December 2013, in a single public tertiary medical center, was carried out. Two hundred fifty seven patients underwent Trans-Urethral Tape (TOT) placement during the study period. One hundred thirty six (52.9%) patients had a TOT placed by an attending specialist in urogynecology (Group A) and 121 (47.1%) by residents, under the guidance of an attending (Group B).
Efficacy of the treatment was evaluated in terms of early postoperative course, reoperation, and patients' symptom improvement, as based on the Pelvic Floor distress inventory-short form (PFDI-20) questionnaire. primary outcome included patient-reported symptoms of stress-type urinary incontinence, as assessed with the use of the PFDI-20 questionnaire. Additional criteria was no surgical retreatment for stress incontinence.
Immediate postoperative complications were comparable in both groups. Subjective failure and self-reported SUI was similar in both groups. The primary outcome, moderate and severe symptoms of SUI were reported by 23.7% of patient in-group A and 23.6% in-group B (p =0.91). Assessments of patients' symptoms, in a mean follow-up of 40 months in both groups, by urinary scale (UDI-6) and prolapse scale (POPDI-6) of PFDI-20, were also similar. Reoperation with repeated sling for USI in both groups was 5%.
The operative results of TOT surgeries for SUI performed by residents under the guidance of an attending specialist in urogynecology did not differ significantly as compared to procedure performed by the attendings themselves.
Journal of minimally invasive gynecology. 2018 Jan 12 [Epub ahead of print]
Osnat Elyashiv, Noa Mevorach Zussman, Masha Ben-Zvi, Jacob Bar, Ron Sagiv, Alexander Condrea, Shimon Ginath
Department of Obstetrics and Gynecology, Edith Wolfson Medical center, Holon, and Sackler Faculty of Medicine, Tel Aviv, Israel. Electronic address: ., Department of Obstetrics and Gynecology, Edith Wolfson Medical center, Holon, and Sackler Faculty of Medicine, Tel Aviv, Israel. Electronic address: ., Department of Obstetrics and Gynecology, Edith Wolfson Medical center, Holon, and Sackler Faculty of Medicine, Tel Aviv, Israel. Electronic address: ., Department of Obstetrics and Gynecology, Edith Wolfson Medical center, Holon, and Sackler Faculty of Medicine, Tel Aviv, Israel. Electronic address: ., Department of Obstetrics and Gynecology, Edith Wolfson Medical center, Holon, and Sackler Faculty of Medicine, Tel Aviv, Israel. Electronic address: ., Department of Obstetrics and Gynecology, Edith Wolfson Medical center, Holon, and Sackler Faculty of Medicine, Tel Aviv, Israel. Electronic address: ., Department of Obstetrics and Gynecology, Edith Wolfson Medical center, Holon, and Sackler Faculty of Medicine, Tel Aviv, Israel. Electronic address: .