Practice patterns in the treatment of female urinary incontinence: A postal and Internet survey

Objectives. To survey American urologists to assess practice patterns in tr eating female incontinence. Advances in the treatment of female incontinenc e have changed the way urologists practice. Methods. Postal and e-mail surveys were sent to 2502 members of the America n Urological Association. Results. From the postal group (n = 1000), 419 (42%) responses were obtaine d; from the e-mail group (n = 1502), 160 (11%) responses were obtained. For types I, II, and III stress urinary incontinence (SUI), 239 (44%) of 546, 388 (68%) of 570, and 512 (94%) of 547 urologists, respectively, recommende d a sling procedure. For type I SUI, 75 (53%) of the 143 respondents in pra ctice for less than 10 years recommended a sling procedure. The sling was r ecommended by 62 (35%) of the 176 respondents in practice for longer than 2 0 years (P <0.001). Most urologists (75%, 358 of 480) referred patients wit h significant vaginal prolapse to a gynecologist; however, urologists in fu ll-time academic practice were more likely to offer surgical treatment (56% , 29 of 52). Most urologists recommended medical treatment for urge inconti nence (94%, 461 of 491), and the medications most commonly selected were to lterodine (41%, 202 of 491), oxybutynin (26%, 129 of 491), and extended-rel ease oxybutynin (25%, 125 of 491). Conclusions. Overall, a sling procedure was the most commonly recommended s urgical procedure for all types of SUI. Most urologists referred patients w ith significant vaginal prolapse to a gynecologist. For type SUI, older uro logists were more likely than younger urologists to perform needle bladder neck suspension. UROLOGY 57: 45-48, 2001. (C) 2001, Elsevier Science Inc.