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Int Urogynecol J. 2018 Jun;29(6):795-801. doi: 10.1007/s00192-017-3476-3. Epub 2017 Sep 15.

The UK National Prolapse Survey: 10 years on.

Author information

1
Urogynaecology Department, Jessop Wing, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, S10 2SF, UK. Swati.Jha@sth.nhs.uk.
2
Urogynaecology Unit, Elizabeth Garrett Anderson Hospital, University College London Hospitals, London, WC1E 6DH, UK.
3
Department of Urogynaecology, Worcester Royal Hospital, Charles Hastings Way, Worcester, WR 5 1DD, UK.

Abstract

INTRODUCTION AND HYPOTHESIS:

To assess trends in the surgical management of pelvic organ prolapse (POP) amongst UK practitioners and changes in practice since a previous similar survey.

METHODS:

An online questionnaire survey (Typeform Pro) was emailed to British Society of Urogynaecology (BSUG) members. They included urogynaecologists working in tertiary centres, gynaecologists with a designated special interest in urogynaecology and general gynaecologists. The questionnaire included case scenarios encompassing contentious issues in the surgical management of POP and was a revised version of the questionnaire used in the previous surveys. The revised questionnaire included additional questions relating to the use of vaginal mesh and laparoscopic urogynaecology procedures.

RESULTS:

Of 516 BSUG members emailed, 212 provided completed responses.. For anterior vaginal wall prolapse the procedure of choice was anterior colporrhaphy (92% of respondents). For uterovaginal prolapse the procedure of choice was still vaginal hysterectomy and repair (75%). For posterior vaginal wall prolapse the procedure of choice was posterior colporrhaphy with midline fascial plication (97%). For vault prolapse the procedure of choice was sacrocolpopexy (54%) followed by vaginal wall repair and sacrospinous fixation (41%). The laparoscopic route was preferred for sacrocolpopexy (62% versus 38% for the open procedure). For primary prolapse, vaginal mesh was used by only 1% of respondents in the anterior compartment and by 3% in the posterior compartment.

CONCLUSION:

Basic trends in the use of native tissue prolapse surgery remain unchanged. There has been a significant decrease in the use of vaginal mesh for both primary and recurrent prolapse, with increasing use of laparoscopic procedures for prolapse.

KEYWORDS:

Cystocele; Laparoscopic urogynaecology; Pelvic organ prolapse; Rectocele; Vaginal mesh; Vault prolapse

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