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An Internet-based survey to evaluate the comfort and need for further pubovaginal sling training

International Urogynecology Journal volume 30, pages 1173–1178 (2019)Cite this article

Abstract

Introduction and hypothesis

The pubovaginal sling (PVS) dates to the 1940s as an efficacious surgical treatment for stress urinary incontinence (SUI). Recently, it has been replaced by the midurethral sling (MUS). Since 2008, international regulatory agencies increased regulation and issued warnings on vaginal mesh for repair of pelvic organ prolapse (POP), which has led to increased scrutiny of the MUS. Thus, the need for surgical comfort with PVS is resurfacing. We sought to evaluate the surgical practice patterns among international urogynecologists for the treatment of SUI and identify whether a need and interest for more training exists.

Methods

We developed a short, Internet-based survey for members of the International Urogynecological Association (IUGA). Descriptive analyses, binomial and multivariate logistic regressions were calculated to determine significant associations.

Results

Among 556 members who responded to the survey, 72% did not offer PVS in practice. Among those who did, there was as significant relationship between offering PVS and practicing in the United States, board-certification in urogynecology, PVS exposure in training, increasing number of PVS performed during training, and comfort with PVS. Members interested in further PVS training were younger, less comfortable with PVS, performed fewer PVS, or had no exposure in training.

Conclusion

Most IUGA members do not offer PVS in clinical practice. As would be expected, members who performed more PVS in training and were more comfortable with PVS were likely to offer it to patients. Our results highlight a learning gap, especially among younger providers who are not comfortable with PVS and desire further training in this procedure.

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Fig. 1

Abbreviations

SUI:

Stress urinary incontinence

PVS:

Pubovaginal sling

MUS:

Midurethral sling

FDA:

Food and Drug Administration

TVT:

Tension-free vaginal tape

POP:

Pelvic organ prolapse

IUGA:

International Urogynecological Association

AUGS:

American Urogynecologic Society

US:

United States

UK:

United Kingdom

TGA:

Therapeutic Goods Administration

FPMRS:

Female Pelvic Medicine and Reconstructive Surgery

SUFU:

Society of Urodynamic and Female Pelvic Medicine and Urogenital Reconstruction

AUA:

American Urological Association

AGSA:

Urogynaecological Society of Australasia

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Funding source

Division of Urogynecology, Department of Obstetrics and Gynecology at University of California, Irvine.

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Affiliations

  1. Department of Obstetrics and Gynecology, University of California, Irvine, 333 City Blvd. West, Suite 1400, Orange, CA, 92868, USA

    Neha T. Sudol, Sonia Dutta & Felicia Lane

Authors
  1. Neha T. Sudol
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  2. Sonia Dutta
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  3. Felicia Lane
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Correspondence to Neha T. Sudol.

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Sudol, N.T., Dutta, S. & Lane, F. An Internet-based survey to evaluate the comfort and need for further pubovaginal sling training. Int Urogynecol J 30, 1173–1178 (2019). https://doi.org/10.1007/s00192-018-3695-2

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  • DOI: https://doi.org/10.1007/s00192-018-3695-2

Keywords

  • Pubovaginal sling
  • Autologous fascia sling
  • Stress urinary incontinence
  • Midurethral sling
  • FDA warning