Rotem Reut, Hickey Muireann, Galvin Daniel, O'Sullivan Suzanne, Brady Ciaran, O'Sullivan Orfhlaith E
Department of Urogynaecology, Cork University Maternity Hospital, Cork, Ireland.
Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, affiliated with the, Hebrew University School of Medicine, Jerusalem, Israel.
Ir J Med Sci. 2025 Jun 18. doi: 10.1007/s11845-025-03986-5.
Mid-urethral slings (MUS) for the surgical management of stress urinary incontinence (SUI) have been suspended in Ireland since July 2018, significantly impacting treatment options and clinical practice.
This study aimed to explore the attitudes of consultant obstetricians, gynaecologists, and urologists in Ireland toward SUI surgery following the MUS suspension, including their prior practices, current approaches, and views on MUS safety and potential reinstatement.
A descriptive, anonymized questionnaire was electronically distributed in early 2023 to consultant members of the Irish Society of Urology and the Continence Foundation of Ireland. Non-consultants, non-medical professionals, and respondents outside Ireland were excluded. Data were analyzed using SPSS v28.
Before the 2018 suspension, 89.5% (17/19) of respondents performed SUI surgeries, with 76.5% (13/17) using MUS-retropubic and 53% (9/17) MUS-transobturator techniques. Post-suspension, 63.2% (12/19) continued performing SUI surgery, primarily urethral bulking (83.3%, 10/12). Regarding safety, 83.3% (15/18) believed MUS led to fewer instances of post-operative voiding dysfunction and 66.7% (12/18) reported fewer complications such as vault prolapse or rectocele. Notably, 44.4% (8/18) had been involved in litigation related to MUS. Despite this, 52.6% (10/19) expressed willingness to resume MUS if the suspension was lifted.
MUS was the preferred SUI procedure prior to suspension due to perceived safety and effectiveness. Over half of consultants surveyed would consider resuming its use, highlighting a need for diverse, evidence-based treatment options and calling for a re-evaluation of the current suspension.
自2018年7月起，爱尔兰已暂停使用治疗压力性尿失禁（SUI）的中段尿道吊带术（MUS），这对治疗选择和临床实践产生了重大影响。
本研究旨在探讨爱尔兰的妇产科顾问医生和泌尿科医生在MUS暂停使用后对SUI手术的态度，包括他们以前的做法、当前的方法以及对MUS安全性和可能恢复使用的看法。
2023年初，一份描述性的匿名问卷通过电子方式分发给爱尔兰泌尿外科学会和爱尔兰尿失禁基金会的顾问成员。非顾问医生、非医学专业人员以及爱尔兰境外的受访者被排除在外。使用SPSS v28对数据进行分析。
在2018年暂停使用之前，89.5%（17/19）的受访者进行SUI手术，其中76.5%（13/17）使用耻骨后MUS技术，53%（9/17）使用经闭孔MUS技术。暂停使用后，63.2%（12/19）的受访者继续进行SUI手术，主要是尿道填充术（83.3%，10/12）。关于安全性，83.3%（15/18）的人认为MUS导致术后排尿功能障碍的情况较少，66.7%（12/18）的人报告并发症如穹窿脱垂或直肠膨出较少。值得注意的是，44.4%（8/18）的人曾参与与MUS相关的诉讼。尽管如此，如果暂停使用解除，52.6%（10/19）的人表示愿意恢复使用MUS。
由于其安全性和有效性，MUS在暂停使用之前是首选的SUI手术方法。超过一半接受调查的顾问医生会考虑恢复使用，这凸显了对多样化、基于证据的治疗选择的需求，并呼吁对当前的暂停使用进行重新评估。
