SURGICAL TRENDS IN THE CORRECTION OF FEMALE STRESS URINARY INCONTINENCE IN ACADEMIC CENTERS

Aims: There is a lack of data describing the current state of stress urinary incontinence ( SUI) procedures in academic centers. Urologists, gynecologists, and urogynecologists perform these operations, but the relative volume each group accounts for is unknown. The purpose of this study was to evaluate the distribution of cases in academic centers between specialties and associated patient characteristics. Methods: A hospital consortium database was used to identify patients treated surgically for SUI between 2009 and 2014. Patient and surgeon variables were evaluated. Patient variables ( age, region, insurance, race) and surgeon volume were analyzed. Sub-analysis was conducted to determine concomitant prolapse repairs. Results: Of the 50,315 stress urinary incontinence procedures performed, 22% were performed by urologists. Overall volume dropped 39% and mean surgeon volumes for all three groups decreased with time. Average median volume for urogynecologists ( 29/year) differed from both urologists ( 3/year) and non-urogynecologists ( 2/year). There was a significant difference in rate of concomitant prolapse repairs performed by urogynecologists ( 56%), gynecologists ( 54%), and urologists ( 26%). Conclusions: These data portray the changing pattern of SUI procedure practice in academic centers. Academic urologists are performing less than 25% of SUI procedures, with an overall decline in number of procedures across all specialties. Urogynecologists and gynecologists are performing a significantly higher proportion of concomitant prolapse repairs. (C) 2015 Wiley Periodicals, Inc.