Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
MultiCare Capital Medical Center, 3900 Capital Mall Dr SW, Olympia, WA, 98502, USA.
Int Urogynecol J. 2024 May;35(5):995-1000. doi: 10.1007/s00192-024-05746-y. Epub 2024 Feb 28.
Vaginal inserts and continence devices are recommended as a conservative treatment option for the management of stress urinary incontinence (SUI); however, practice patterns for recommendation and use of such devices are currently unknown. Our objectives were to better understand counseling patterns relating to over-the-counter (OTC) continence devices, to assess perceived barriers to recommending these devices, and to estimate clinician familiarity with three such devices currently available in the USA.
In this cross-sectional study, an anonymous electronic survey was distributed to all Accreditation Council for Graduate Medical Education-accredited OB/GYN and Urology residency and Female Pelvic Medicine and Reconstructive Surgery (FPMRS) fellowship programs. A total of 326 survey responses were collected. Multivariate logistic regression was used to assess respondent characteristics associated with recommending OTC continence devices to patients.
Sixty-four percent of respondents expressed familiarity with any OTC continence device. Of respondents who reported regular evaluation and treatment of women with SUI (n = 269), 60% reported ever recommending OTC devices for SUI. On multivariate regression, being a trainee and general OB/GYN provider were associated with being less likely to recommend OTC devices for SUI. Of respondents who did not regularly recommend OTC continence devices, reported barriers to doing so included a lack of training with these devices, leading to clinician discomfort (70%) and not remembering OTC devices as an option (15%).
Given the low risk associated with patient use of these easily accessible devices, our study highlights barriers to clinician recommendation with the goal of increasing clinician awareness and consideration of OTC continence devices.
阴道植入物和控尿装置被推荐作为治疗压力性尿失禁（SUI）的保守治疗选择；然而，目前尚不清楚这些装置的推荐和使用的实践模式。我们的目的是更好地了解与非处方（OTC）控尿装置相关的咨询模式，评估推荐这些装置的障碍，并估计临床医生对目前在美国可用的三种此类装置的熟悉程度。
在这项横断面研究中，我们向所有获得研究生医学教育认证委员会（ACGME）认证的妇产科和泌尿科住院医师以及女性盆底医学和重建手术（FPMRS）奖学金项目的医生分发了匿名电子调查。共收集了 326 份调查回复。我们使用多变量逻辑回归来评估与向患者推荐 OTC 控尿装置相关的受访者特征。
64%的受访者表示熟悉任何一种 OTC 控尿装置。在报告定期评估和治疗 SUI 女性的受访者（n=269）中，60%的人报告曾推荐过 OTC 装置治疗 SUI。在多变量回归中，作为受训者和一般妇产科医生与不太可能推荐 OTC 装置治疗 SUI 相关。在不经常推荐 OTC 控尿装置的受访者中，报告的障碍包括缺乏这些装置的培训，导致临床医生感到不适（70%）和不记得 OTC 装置是一种选择（15%）。
鉴于这些易于获得的装置对患者使用的风险较低，我们的研究强调了临床医生推荐的障碍，旨在提高临床医生的意识并考虑 OTC 控尿装置。
