{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T18:42:26Z","timestamp":1789756946712,"version":"4.0.1"},"reference-count":9,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2021,6,23]],"date-time":"2021-06-23T00:00:00Z","timestamp":1624406400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,6,23]],"date-time":"2021-06-23T00:00:00Z","timestamp":1624406400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"RCSI\u2014Blackrock Clinic StAR MD Programme 2020"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int Urogynecol J"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Introduction and hypothesis<\/jats:title>\n                <jats:p>The aim of this study is to evaluate the trends in stress urinary incontinence (SUI) surgery since the 2018 pause on use of the polypropylene (PP) mid-urethral sling (MUS) and to quantify the effect this has had on surgical training.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Two anonymous surveys were sent to all current urology trainees and to all consultant surgeons who specialise in stress urinary incontinence surgery.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Prior to the pause, 86% (6 out of 7) of consultant urologists and 73% (11 out of 15) of consultant gynaecologists would \u201calways\u201d\/\u201coften\u201d perform MUS for SUI. After that, 100% (22 out of 22) of consultants reported that they \u201cnever\u201d perform MUS. There has been a modest increase in the use of urethral bulking agent (UBA) procedures among urologists, with 43% (3 out of 7) now \u201coften\u201d performing this, compared with 71% (5 out of 7) \u201cnever\u201d performing it pre-2018. Trainee exposure to SUI surgery reduced by 75% between 2016 and 2020. Despite a ten-fold increase in UBA procedures logged by trainees, the decline in MUS has resulted in a major reduction in total SUI surgeries. Coinciding with this decrease in surgeries, there was a 56% reduction in trainees\u2019 self-assessed competence at SUI surgery. Thirteen percent of trainees are interested in specialising in Female Urology and those trainees had significantly greater exposure to SUI procedures during their training than those who did not (<jats:italic>p\u2009=<\/jats:italic>\u00a00.0072).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>This study has identified a downward trend in SUI surgery, which is concerning for the undertreatment of females with SUI. A decline in SUI surgery training has resulted in reduced trainee confidence and interest in this subspecialty.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00192-021-04887-8","type":"journal-article","created":{"date-parts":[[2021,6,23]],"date-time":"2021-06-23T08:02:58Z","timestamp":1624435378000},"page":"2841-2846","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Contemporary trends for urological training and management of stress urinary incontinence in Ireland"],"prefix":"10.1007","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5814-0722","authenticated-orcid":false,"given":"Eoin","family":"MacCraith","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James C.","family":"Forde","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fergal J.","family":"O\u2019Brien","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niall F.","family":"Davis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,6,23]]},"reference":[{"issue":"2","key":"4887_CR1","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1002\/ijgo.12932","volume":"147","author":"A Ugianskiene","year":"2019","unstructured":"Ugianskiene A, Davila GW, Su TH. FIGO review of statements on use of synthetic mesh for pelvic organ prolapse and stress urinary incontinence. Int J Gynaecol Obstet. 2019;147(2):147\u201355.","journal-title":"Int J Gynaecol Obstet"},{"key":"4887_CR2","unstructured":"Department of Health, Ireland (2018) Minister for Health Simon Harris announces pause in the use of transvaginal mesh devices. Available from: https:\/\/www.gov.ie\/en\/press-release\/6c85c7-minister-for-health-simon-harris-announces-pause-in-the-use-of-trans\/. Accessed 1 Mar 2021"},{"key":"4887_CR3","doi-asserted-by":"publisher","DOI":"10.1111\/bju.15302","author":"R Mathieson","year":"2020","unstructured":"Mathieson R, Kippen R, Manning T, Brennan J. Stress urinary incontinence in the mesh complication era: current Australian trends. BJU Int. 2020. https:\/\/doi.org\/10.1111\/bju.15302","journal-title":"BJU Int"},{"key":"4887_CR4","unstructured":"ISCP, Intercollegiate Surgical Curriculum Programme. Urology Curriculum. 2021. Available from: www.iscp.ac.uk Accessed 2nd March 2021."},{"key":"4887_CR5","unstructured":"Burkhard FC, Bosch JLHR, Cruz F. EAU Guidelines on Urinary Incontinence in Adults 2018, in European Association of Urology Guidelines. 2018 Edition. European Association of Urology Guidelines Office: Arnhem, The Netherlands."},{"issue":"2","key":"4887_CR6","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1097\/JU.0000000000000569","volume":"203","author":"UJ Lee","year":"2020","unstructured":"Lee UJ, Feinstein L, Ward JB, et al. National trends in the surgical management of urinary incontinence among insured women, 2004 to 2013: the Urologic Diseases in America Project. J Urol. 2020;203(2):365\u201371.","journal-title":"J Urol"},{"key":"4887_CR7","unstructured":"Rogers E, Lonergan P. Urology: a model of care for Ireland. 2019. Available from: https:\/\/www.rcsi.com\/surgery\/-\/media\/feature\/media\/download-document\/surgery\/practice\/publications-and-guidelines\/models-of-care\/urology--a-model-of-care-for-ireland.pdf. Accessed 23 December 2020"},{"issue":"7","key":"4887_CR8","first-page":"CD001754","volume":"7","author":"H Rehman","year":"2017","unstructured":"Rehman H, Bezerra CA, Bruschini H, Cody JD, Aluko P. Traditional suburethral sling operations for urinary incontinence in women. Cochrane Database Syst Rev. 2017;7(7):CD001754.","journal-title":"Cochrane Database Syst Rev"},{"key":"4887_CR9","doi-asserted-by":"crossref","unstructured":"Kirchin V, Page T, Keegan PE, Atiemo K, Cody JD, McClinton S. Urethral injection therapy for urinary incontinence in women. Cochrane Database Syst Rev. 2012;(2):CD003881.","DOI":"10.1002\/14651858.CD003881.pub3"}],"container-title":["International Urogynecology Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00192-021-04887-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00192-021-04887-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00192-021-04887-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,21]],"date-time":"2021-09-21T14:21:13Z","timestamp":1632234073000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00192-021-04887-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,23]]},"references-count":9,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2021,10]]}},"alternative-id":["4887"],"URL":"https:\/\/doi.org\/10.1007\/s00192-021-04887-8","relation":{},"ISSN":["0937-3462","1433-3023"],"issn-type":[{"value":"0937-3462","type":"print"},{"value":"1433-3023","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,23]]},"assertion":[{"value":"20 April 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 May 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 June 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This research was funded by the RCSI Blackrock Clinic StAR MD programme 2020.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Financial disclaimers\/conflict of interest"}},{"value":"Institutional review board (IRB) approval was granted for this study (Research Ethics Committee reference REC202101012). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1975 Declaration of Helsinki and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics statement"}}]}}