The French journal of urology · 2025
Trends in surgical treatment of female stress urinary incontinence in France over the past decade (2015-2024).
СтатьяНазвание и аннотация: Перевод в очереди
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Richard Claire, Cornu Jean-Nicolas, Thuillier Caroline, Brandon Caroline, Campagne-Loiseau Sandrine, Bosset Pierre-Olivier, Donon Laurence, Even Lucie, Girard Frederic, Haddad Rebecca, Herve François, Hurel Sophie, Klap Julia, Meyer François, Plassais Caroline, Thubert Thibault, Vidart Adrien, Peyronnet Benoit
Аннотация
INTRODUCTION: Over the past decade, the COVID-19 crisis, controversies, and subsequent regulations regarding the use of polypropylene mid-urethral slings have likely influenced surgical practice in the management of female stress urinary incontinence (SUI). The aim of this study was to assess the evolution of surgical techniques for female SUI over the last 10 years.
METHODS: National activity data were extracted from the PMSI (Programme de Médicalisation des Systèmes d'Information) database using the online OpenCCAM tool. The analysis included procedures coded between 2015 and 2024: transobturator sling (TOT, JDDB005), retropubic sling (TVT, JDDB007), Burch colposuspension (JDDA002 and JDDC002), autologous fascial sling (JDDA004), bulking agents (JELE001), and artificial urinary sphincter (AUS, JELA001). Adjustable balloons were excluded due to the absence of a specific code.
RESULTS: Between 2015 and 2024, TOT use decreased by 69%, from 25,225 to 7887 procedures. TVT remained stable at around 6800 procedures annually after a temporary decline during the COVID period. Burch colposuspension decreased threefold, with a shift toward laparoscopic approaches. Autologous sling procedures doubled but remained rare (89 cases in 2024). Bulking agents injections increased exponentially, multiplying ninefold (226 to 2,123). AUS use remained stable. Mean hospital stay (LOS) decreased across all techniques, particularly for slings (TOT: 1.6 to 0.6 days; TVT: 1.8 to 0.5 days).
CONCLUSION: Over the past decade, surgical management of female SUI in France has profoundly evolved: a marked decline in TOT, an exponential rise in bulking agents, stable use of TVT, and diversification of alternatives. Current practice is moving toward shorter hospital stays, broader therapeutic options, and greater adaptation to patient profiles and preferences.
METHODS: National activity data were extracted from the PMSI (Programme de Médicalisation des Systèmes d'Information) database using the online OpenCCAM tool. The analysis included procedures coded between 2015 and 2024: transobturator sling (TOT, JDDB005), retropubic sling (TVT, JDDB007), Burch colposuspension (JDDA002 and JDDC002), autologous fascial sling (JDDA004), bulking agents (JELE001), and artificial urinary sphincter (AUS, JELA001). Adjustable balloons were excluded due to the absence of a specific code.
RESULTS: Between 2015 and 2024, TOT use decreased by 69%, from 25,225 to 7887 procedures. TVT remained stable at around 6800 procedures annually after a temporary decline during the COVID period. Burch colposuspension decreased threefold, with a shift toward laparoscopic approaches. Autologous sling procedures doubled but remained rare (89 cases in 2024). Bulking agents injections increased exponentially, multiplying ninefold (226 to 2,123). AUS use remained stable. Mean hospital stay (LOS) decreased across all techniques, particularly for slings (TOT: 1.6 to 0.6 days; TVT: 1.8 to 0.5 days).
CONCLUSION: Over the past decade, surgical management of female SUI in France has profoundly evolved: a marked decline in TOT, an exponential rise in bulking agents, stable use of TVT, and diversification of alternatives. Current practice is moving toward shorter hospital stays, broader therapeutic options, and greater adaptation to patient profiles and preferences.