The French journal of urology · 2026
Impact of new decrees on pelvic implant surgery in France: Results of a national survey among urologists and gynecologists.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Meyer Francois, Thuillier Caroline, Thubert Thibault, Hurel Sophie, Klap Julia, Brandon Caroline, Campagne-Loiseau Sandrine, Bosset Pierre-Olivier, Donon Laurence, Even Lucie, Florin Marie, Girard Frederic, Haddad Rebecca, Hervé François, Richard Claire, Vidart Adrien, Plassais Caroline, Cornu Jean-Nicolas, Peyronnet Benoit
Аннотация
INTRODUCTION: Recent decrees conditioning the placement of pelvic implants on a minimum annual activity threshold per institution have raised concerns. A survey was conducted among French urologists and gynecologists to assess their practices and perceptions of these measures.
METHODS: An online questionnaire was distributed via three scientific societies (AFU, CNGOF, SCGP) in May 2025. It covered four themes: respondents' characteristics, experience in pelviperineology, impact of the new decrees, and opinions on surgical thresholds. The response collection period was 21days, with a reminder after one week.
RESULTS: A total of 431 practitioners responded (60% urologists, 40% gynecologists; 64% male; 34% aged 41-50). The majority worked in private practices (52%) and were trained in pelviperineology (61%). Regarding activity, 67% and 66% exceeded the thresholds for incontinence and pelvic organ prolapse (POP), respectively, but 18% and 18% did not meet them. Most incontinence procedures involved mid-urethral slings; 51% of respondents used only TVT, and 29% only TOT. For POP, sacrocolpopexy was the sole procedure performed by 9% of gynecologists and 61% of urologists. Among the latter, 59% did not perform Richter sacrospinous ligament fixation (vs. 6% of gynecologists). The perceived impact of the decrees was significant: 53% of practitioners (including 67% of urologists) reported a desire to withdraw from the management of female incontinence, and 46% from POP (including 79% of urologists). If authorization were lost, 71% would stop implanting meshes and 60% would refer patients elsewhere. Only 32% believed the thresholds would improve patient care. For 61% of practitioners, they did not guarantee individual experience, and for 51%, they did not reflect quality of care. Most respondents considered a threshold of 10 annual procedures more appropriate for POP and incontinence, and 78% believed that validation of specialized training would be more relevant than activity thresholds (78% among urologists).
DISCUSSION: This survey highlights a real risk of practitioner disengagement, particularly among urologists, potentially detrimental to healthcare provision. Thresholds are perceived as inadequate, and recognition of individual competence appears preferable.
METHODS: An online questionnaire was distributed via three scientific societies (AFU, CNGOF, SCGP) in May 2025. It covered four themes: respondents' characteristics, experience in pelviperineology, impact of the new decrees, and opinions on surgical thresholds. The response collection period was 21days, with a reminder after one week.
RESULTS: A total of 431 practitioners responded (60% urologists, 40% gynecologists; 64% male; 34% aged 41-50). The majority worked in private practices (52%) and were trained in pelviperineology (61%). Regarding activity, 67% and 66% exceeded the thresholds for incontinence and pelvic organ prolapse (POP), respectively, but 18% and 18% did not meet them. Most incontinence procedures involved mid-urethral slings; 51% of respondents used only TVT, and 29% only TOT. For POP, sacrocolpopexy was the sole procedure performed by 9% of gynecologists and 61% of urologists. Among the latter, 59% did not perform Richter sacrospinous ligament fixation (vs. 6% of gynecologists). The perceived impact of the decrees was significant: 53% of practitioners (including 67% of urologists) reported a desire to withdraw from the management of female incontinence, and 46% from POP (including 79% of urologists). If authorization were lost, 71% would stop implanting meshes and 60% would refer patients elsewhere. Only 32% believed the thresholds would improve patient care. For 61% of practitioners, they did not guarantee individual experience, and for 51%, they did not reflect quality of care. Most respondents considered a threshold of 10 annual procedures more appropriate for POP and incontinence, and 78% believed that validation of specialized training would be more relevant than activity thresholds (78% among urologists).
DISCUSSION: This survey highlights a real risk of practitioner disengagement, particularly among urologists, potentially detrimental to healthcare provision. Thresholds are perceived as inadequate, and recognition of individual competence appears preferable.