To investigate doctors' opinions of the use of synthetic mesh for the treatment of stress urinary incontinence (SUI) and the effect on patient's attitude following recent adverse publicity and legal findings.
Electronic Survey approved by International Urogynecological Association (IUGA) and American Urogynecologic Society (AUGS), distributed to their members.
593 respondents completed the Survey. The preferred initial surgical treatment for SUI was retropubic Midurethral sling (MUS) (62%), followed by trans-obturator MUS (19%), mini-slings (10%) and then bulking agents (5%). Despite prolongation of consultation, majority of respondents (87%) believed that clinicians should provide patient information leaflet (PIL) to their patients. However, only 70% of respondents are doing this in practise. Majority of participants would use either IUGA or their institution PIL (61%). Only 8% felt that patients have a positive preconception of synthetic mesh for SUI. Eighty three percent of respondents haven't changed their recommendations for treatment and consent process. A logistic regression model identified preferences of certain geographic areas as predictors of consenting practises.
Despite the negative publicity and the current medicolegal litigation involving MUS for SUI treatment, the majority of respondents still prefer this as the initial surgical treatment. Most clinicians value PIL in the surgical consent process.
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics. 2022 Aug 20 [Epub ahead of print]
Ariel Zilberlicht, Debjyoti Karmakar, Peter L Dwyer, Garson Chan, Lore Schierlitz
Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, The Lady Davis Carmel Medical Center, Technion University, Rappaport Faculty of Medicine, Haifa, Israel., Department of Urogynaecology, Mercy Hospital for Women, Melbourne, Victoria, Australia., Division of Urology Department of Surgery, University of Saskatchewan.