Variability in practice patterns in stress urinary incontinence and pelvic organ prolapse: results of an IUGA survey

Kammerer-Doak, Dorothy; Švabík, Kamil; Bazi, Tony

doi:10.1007/s00192-016-3174-6

Cited by 16 publications

(12 citation statements)

References 15 publications

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“…However, significant regional differences were present; the number of providers prescribing a pessary was highest in North America and lowest in Africa. 55 It is worth noting that this percentage was significantly higher (52%, p =0.008) than that noted in 2013. Other studies reported that pessaries are being used in daily practice by 86% of gynecologists and 98% of urogynecologists.…”

Section: Advantages Of Pessary Usementioning

confidence: 57%

“…Results of a survey conducted by the International Urogynecological Association 55 regarding practice patterns in women with SUI indicated that 61.5% of medical practitioners worldwide always or frequently offer a pessary to patients with SUI associated with POP. No difference was found among these practitioners in their academic affiliation.…”

Section: Advantages Of Pessary Usementioning

confidence: 99%

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Pessary use in stress urinary incontinence: a review of advantages, complications, patient satisfaction, and quality of life

Al‐Shaikh¹,

Syed²,

Osman³

et al. 2018

IJWH

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Stress urinary incontinnce (SUI) is a common condition among women. The usual approach to treatment of SUI is a stepwise plan from conservative to surgical procedures. A vaginal pessary is one of the commonly used conservative treatments that offer symptomatic improvement for women with incontinence. This review provides a critical analysis of the benefits and shortcomings offered by vaginal pessaries to patients affected by SUI, with a particular focus on indications, advantages, quality of life, patient satisfaction, and potential complications. To obtain the required information, an extensive search of PubMed and Cochrane databases was performed, covering the time frame from January 2000 to December 2016. We also surveyed the published guidelines of American Urological Association, Canadian Urological Association, American Urogynecological Society, National Institutes of Health (USA), and National Institute for Health and Care Excellence (UK). A total of 192 original research papers, review articles, and clinical trials were identified. The analysis of retrieved data provides evidence that vaginal pessaries constitute an effective nonsurgical option for SUI. The satisfaction rate with pessary use is high and only minor complications, if any, occur, vaginal discharge being the most common. The reviewed studies document that vaginal pessaries provide an adequate control of SUI if they are fit properly and managed by frequent replacements and regular checkups. They should be considered among the first line of treatment for SUI associated with exercise and increased intra-abdominal pressure.

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Section: Advantages Of Pessary Usementioning

confidence: 57%

Section: Advantages Of Pessary Usementioning

confidence: 99%

Pessary use in stress urinary incontinence: a review of advantages, complications, patient satisfaction, and quality of life

Al‐Shaikh¹,

Syed²,

Osman³

et al. 2018

IJWH

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“…The 22.2% response rate to the online survey is consistent with the response rates of similar surveys conducted internationally. [ 4 5 6 7 ] While the South Zone accounted for maximum number of responses received (171), the highest percentage response was from the North Zone. East zone members were significantly less likely to be working in a teaching hospital.…”

Section: Discussionmentioning

confidence: 99%

“…Transobturator tape was the preferred surgical option for SUI for 71.6% of the respondents. In a global survey, 49.7% of respondents chose this surgery as their default option[ 5 ] regardless of other factors. [ 18 ] Nationwide hospital statistics from England showed that tapes constituted about 98% of all SUI surgeries in 2012 with transobturator tapes being 1.7 times more common than the retropubic ones.…”

Section: Discussionmentioning

confidence: 99%

The Urological Society of India survey on urinary incontinence practice patterns among urologists

et al. 2018

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Introduction:The Urological Society of India guidelines panel on urinary incontinence (UI) conducted a survey among its members to determine their practice patterns in the management of UI. The results of this survey are reported in this manuscript.Methods:An anonymous online survey was carried out among members of the USI to determine their practice patterns regarding UI using a predeveloped questionnaire on using SurveyMonkey®. A second 4-question randomized telephonic survey of the nonresponders was performed after closure of the online survey. Data were analyzed by R software 3.1.3 (P < 0.05 significant).Results:A total of 468 of 2109 (22.2%) members responded to the online survey. Nearly 97% were urologists, 74.8% were working at a private, and 39.4% were in an academic institution. Almost all were managing UI. 84.2% had local access to a urodynamics (UDS) facility. 85.8% would check postvoid residual urine for all the patients. Voiding diary, symptom scores, quality of life scores, pad test, Q-tip test, stress test, uroflow, and cystoscopy were ordered as part of evaluation by 86.0%, 49.8%, 24.4%, 22.0%, 6.0%, 71.8%, 69.2%, and 34.7%, respectively. 47.6% would order a UDS for patients with urgency UI who fail conservative treatment. 36.9% would get UDS prior to all stress UI surgery. Seventy-five percent would make a diagnosis of intrinsic sphincter deficiency. Solifenacin was the first choice for urgency UI in general and darifenacin was preferred in elderly. Botulinum was the first choice for refractory urgency UI. Midurethral sling was the commonest procedure for surgical management of SUI (95.1%). 147 of the 1641 non responders were randomly sampled telephonically. Telephonic respondents had similar access to UDS facility but had performed fewer lifetime number of post-prostatectomy incontinence (PPI) surgeries. Combining data from both surveys, total number of artificial sphincters and PPI surgeries ever performed by USI members was estimated at 375 and 718 respectively.Conclusion:This survey provides important new data and elicits critical differences in management practices based on demographics.

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“…There are different therapeutic methods that aim at improving these dysfunctions, such as electrostimulation, vaginal cones, biofeedback, pelvic floor muscle training (PFMT), and the use of pessaries [4][5][6]. despite limited evidence, the pessary is commonly used in the treatment of genital prolapse and presented in 77% of cases as the first line treatment by the American Urogynecologic Society (AUGS) [7].…”

Section: Introductionmentioning

confidence: 99%

Use of pessary in the treatment of pelvic floor dysfunctions: a systematic review

Scarabelot¹,

Pereira²,

Ghizzo³

et al. 2018

Physiother Quart.

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Introduction. To describe and evaluate the scientific evidence on the use of pessary in the treatment of pelvic floor dysfunctions.Methods. This systematic review was performed in accordance with the Preferred Reporting items for Systematic Reviews and Meta-Analyses (PRiSMA) guidelines. The databases searched were Sciencedirect, PubMed, PEdro, and BVS. The following descriptors were used: 'clinical trial,' 'pessary,' 'pelvic floor,' and the Boolean operator 'and.' The search was conducted between November 2016 and February 2017. The methodological quality of the selected articles was analysed with the Physiotherapy Evidence database (PEdro) scale.Results. After the insertion of the filters in the databases, 379 titles were selected, of which 5 articles were picked out in pairs for analysis as a whole. The 3 studies investigating the use of pessary in the treatment of pelvic organ prolapse included women with prolapse stages ii-iii. The rings or Gellhorn pessaries were the most frequently used, and all showed benefits in decreasing urinary symptoms and improvement of prolapse.Conclusions. The pessary is beneficial for the treatment of urinary incontinence and pelvic organ prolapse. Good methodological quality was also identified in most studies included.

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Variability in practice patterns in stress urinary incontinence and pelvic organ prolapse: results of an IUGA survey

Abstract: Many practice patterns in the evaluation and treatment of POP and SUI depend on academic affiliation and geographic location. Practice patterns are not always based on most recent evidence-based data.

Cited by 16 publications

References 15 publications

Pessary use in stress urinary incontinence: a review of advantages, complications, patient satisfaction, and quality of life

Pessary use in stress urinary incontinence: a review of advantages, complications, patient satisfaction, and quality of life

The Urological Society of India survey on urinary incontinence practice patterns among urologists

Use of pessary in the treatment of pelvic floor dysfunctions: a systematic review

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