[Distribution of surgical operations for female stress urinary incontinence in parisian public hospitals in 2002-2003].

Objective: To determine the surgical practices for the treatment of female stress urinary incontinence (SUI) in Parisian public hospitals (AP-HP) over a 12-month period.
Material and Methods: 25 gynaecology (n=16) and urology (n=9) departments in Parisian teaching hospitals were surveyed by postal questionnaire concerning their surgical practice for female SUI. The survey concerned all operations performed between 1st' September 2002 and 31st August 2003 inclusive. The questionnaire concerned the number of operations, the type of operation, the type of suburethral tape and the incision used for placement of these tapes.
Results: The participation rate in the survey was 88% (22 out of 25 departments). The total number of surgical operations for SUI was 1,224: 586 in gynaecology (47.9%) and 638 in urology (52.1%). The distribution of techniques was as follows: 1,028 suburethral slings by prosthetic tape (83.9%), 106 retropubic colposuspensions (8.7%), 70 artificial sphincters (5.7%), 13 subcervical slings (1.1%) and 7 transurethral injections (0.6%). The distribution of tapes was as follows: 614 TVT (59.7%), 217 T.O.T. (21.1%), 111 SPARC, (10.8%) 40 PROLENE (3.9%), 27 URETEX (2.6%), 7 PELVICOL (0.7%), 6 SIS (0.6%) and 6 IVS (0.6%). Surgical approaches consisted of an ascending retropubic approach in 60.2% of cases, a transobturator approach in 26.9% of cases, a descending retropubic approach in 10.8% of cases and a prepubic approach in 2.1% of cases.
Conclusion: Ascending retropubic TVT represented the majority of operations for female stress urinary incontinence performed in Parisian public hospitals in 2002-2003. The obturator approach represented almost one-third of surgical approaches for suburethral tape placement.