Symptomatic stress urinary incontinence not demonstrated clinically: survey of practice patterns

The aim of this study was to survey obstetrician/gynecologists and urologists regarding management of women undergoing hysterectomy with complaints of stress urinary incontinence (SUI) not demonstrated clinically. A survey was distributed electronically to military healthcare system OB/GYN and urologist physicians. Overall descriptive data and responses analyzed according to respondent demographics and the presence or absence of pelvic organ prolapse are reported. Two-hundred forty-two responses were obtained (44% response rate). Without prolapse, only 32% would perform an anti-incontinence procedure, more often by urologists than OB/GYN physicians. With prolapse, more respondents would perform an anti-incontinence procedure (32% increasing to 59%, p<0.001). A mid-urethral sling was the most common procedure that was offered. Trainee versus attending status and teaching versus non-teaching responsibilities did not affect responses. There is no consensus among military obstetricians/gynecologists and urologists regarding management of women otherwise undergoing pelvic surgery with subjective SUI. The presence of prolapse influences this decision.