DIFFERENCES AMONG UROLOGISTS AND GYNECOLOGISTS WHO TREAT URINARY INCONTINENCE AND PELVIC FLOOR PROLAPSE
 

Authors:

S. Madjar, D. Evans, R. C. Duncan, A. E. Gousse.
   

Institution:

University of Miami, Florida, USA.
     

Conference:

ICS 2000 Tampere
       

Type:

Informally discussed posters
         

Category:

Treatment of Incontinence
                 

Aims of study:
Both urologists and gynecologists are involved in the care for women with urinary incontinence (UI) and pelvic floor prolapse (PFP). This study is designed to characterize the differences between these professionals in regard to their background characteristics, current practices, and the preferred surgical approaches to the treatment of UI and PFP.

Methods:
A 14-question survey was mailed to the International Continence Society (ICS) members.

Results:
Among the 229 responders (34.4% response rate), 63.7% are urologists and 36.2% are gynecologists. Statistically significant differences among urologists and gynecologists who treat UI and PFP are summarized in table 1:

Professional time dedicated to UI & PFP ³ 50%

Urol.s

(N=146)

29.4%

Gynecol.s

(N=83)

74.7%

p Value

.001

UI & PFP Fellowship trained

58.2%

75.9%

.029

UI and PFP procedures per week ³2

41.7%

83.1%

.001

Preferred procedures for SUI*:  Vaginal suspension

Retropubic suspension

Sling procedure

Minimally invasive

18.5%

45.2%

50.0%

28.0%

3.6%

59.0%

16.9%

54.2%

.006

N/S

.001

.001

Do not correct vaginal vault prolapse/enterocele 

57.5%

8.4%

.001

Collaborate in the operating room

70.6%

44.6%

.001

Familiarity with all aspects of Sx. as a reason for not collaborating

31.5%

67.5%

.001

Collaborate in the diagnosis of challenging cases

71.2%

85.5%

.011

 

 

 

 

 

 

 

 

 

 

 

 

 

*More than one procedure could be selected

Conclusions:
Urologists and gynecologists who deal with UI and PFP differ significantly in their background training, time dedicated to UI and PFP, and the volume of procedures performed. They differ also in their preferred surgical procedures and their sense of mastering the operative techniques to correct PFP. We propose that future fellowship programs exposing trainees to both field of expertise will enable better ground for collaboration and improved care for women with UI and PFP.