{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T16:56:28Z","timestamp":1770742588978,"version":"3.49.0"},"reference-count":25,"publisher":"Georg Thieme Verlag KG","issue":"03","license":[{"start":{"date-parts":[[2024,3,6]],"date-time":"2024-03-06T00:00:00Z","timestamp":1709683200000},"content-version":"vor","delay-in-days":5,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Geburtshilfe Frauenheilkd"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Changes in surgical practice patterns to cure stress urinary incontinence (SUI) became evident after FDA warnings regarding vaginal mesh were issued. The primary aim was to describe\n        nationwide numbers of suburethral alloplastic slings (SAS) inserted in 2010, 2015, 2018 and 2021 in Germany. Secondary, numbers were related to SUI specific non-alloplastic alternatives and\n        bulking agents. Additionally, age distribution and overall inpatient surgeries in women were subject to analysis.<\/jats:p><jats:p>Descriptive study utilizing data gathered from the German Federal Statistical Office (www.destatis.de). Included were the following procedures of\n        inpatient surgery: A. SAS; B. non-allplastic slings; C. open\/laparoscopic colposuspension; D. Bulking agents; overall changes and changes in age distribution (groups of 5-years intervals) are\n        described.<\/jats:p><jats:p>Overall, n\u00a0=\u00a03599466 female inpatient procedures were analyzed. There was a considerable decrease of SAS surgeries of 28.49% between 2010 (n\u00a0=\u00a023464) and 2015 (n\u00a0=\u00a016778), and a decrease\n        of 12.42% between 2015 and 2018 (n\u00a0=\u00a014695) and an additional decrease of 40.66% between 2018 and 2021 (n\u00a0=\u00a08720). Over time a 55.03% continuous decrease in non-alloplastic slings was observed\n        (n\u00a0=\u00a0725 in 2010 to n\u00a0=\u00a0326 in 2021). Open and laparoscopic colposuspension numbers went down with a rate of 58.23% (n\u00a0=\u00a04415 in 2010, n\u00a0=\u00a01844 in 2021). Between 2010 and 2018, only bulking\n        agent procedures increased with a rate of 5.89% from n\u00a0=\u00a01425 to n\u00a0=\u00a01509.<\/jats:p><jats:p>There was a considerable decrease in inpatient surgical procedures using SAS. Alternatives not only failed to compensate, but experienced also a major decline.<\/jats:p>","DOI":"10.1055\/a-2243-2341","type":"journal-article","created":{"date-parts":[[2024,3,7]],"date-time":"2024-03-07T00:29:23Z","timestamp":1709771363000},"page":"256-263","source":"Crossref","is-referenced-by-count":2,"title":["Surgical Procedures for the Treatment of Stress Urinary Incontinence (SUI) in the Light of the Updated FDA-Warning and its Effects on Practice Patterns in Germany between 2010 and 2021"],"prefix":"10.1055","volume":"84","author":[{"given":"Gert","family":"Naumann","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Helios Hospital Erfurt, Erfurt, Germany"},{"name":"Department of Obstetrics and Gynecology, University of D\u00fcsseldorf, D\u00fcsseldorf, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4906-7751","authenticated-orcid":false,"given":"Markus","family":"Huebner","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Medical Center \u2013 University of Freiburg, Freiburg, Germany"},{"name":"Faculty of Medicine, University of Freiburg, Freiburg, Germany"},{"name":"Faculty of Medicine, University of T\u00fcbingen, T\u00fcbingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florin-Andrei","family":"Taran","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Medical Center \u2013 University of Freiburg, Freiburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ralf","family":"Tunn","sequence":"additional","affiliation":[{"name":"Department of Urogynecology, German Pelvic Floor Center, St. Hedwig Hospital, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christl","family":"Reisenauer","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of T\u00fcbingen, T\u00fcbingen, Germany"},{"name":"Department of Women\u02bcs Health, University Hospital of T\u00fcbingen, T\u00fcbingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7343-561X","authenticated-orcid":false,"given":"Felix","family":"Neis","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of T\u00fcbingen, T\u00fcbingen, Germany"},{"name":"Department of Women\u02bcs Health, University Hospital of T\u00fcbingen, T\u00fcbingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,3,6]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1007\/s00120-022-02017-w","article-title":"[Slings in the era of the mesh ban: now what?]","volume":"62","author":"G Naumann","year":"2023","journal-title":"Urologie"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1007\/BF01902378","article-title":"An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence","volume":"7","author":"U Ulmsten","year":"1996","journal-title":"Int Urogynecol J Pelvic Floor Dysfunct"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1038\/ncpuro1052","article-title":"The evolution of midurethral slings","volume":"5","author":"DE Rapp","year":"2008","journal-title":"Nat Clin Pract Urol"},{"issue":"07","key":"ref4","doi-asserted-by":"publisher","first-page":"CD006375","DOI":"10.1002\/14651858.CD006375.pub4","article-title":"Mid-urethral sling operations for stress urinary incontinence in women","author":"AA Ford","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"706","DOI":"10.1007\/s00120-021-01530-8","article-title":"[Alloplastic material in the treatment of urinary incontinence]","volume":"60","author":"M Grabbert","year":"2021","journal-title":"Urologe A"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1055\/a-1967-1726","article-title":"Diagnosis and Therapy of Female Urinary Incontinence. Guideline of the DGGG, OEGGG and SGGG (S2k-Level, AWMF Registry No.\u2009015\/091, January 2022): Part 1 with Recommendations on\n          Diagnostics and Conservative and Medical Treatment","volume":"83","author":"G Naumann","year":"2023","journal-title":"Geburtshilfe Frauenheilkd"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"410","DOI":"10.1055\/a-1967-1888","article-title":"Diagnosis and Therapy of Female Urinary Incontinence. Guideline of the DGGG, OEGGG and SGGG (S2k Level, AWMF Registry No. 015\/091, January 2022): Part 2 with Recommendations on\n          Interventional\/Surgical Therapy of Overactive Bladder, Surgical Treatment of Stress Urinary Incontinence and Diagnosis and Therapy of Iatrogenic Urogenital Fistula","volume":"83","author":"G Naumann","year":"2023","journal-title":"Geburtshilfe Frauenheilkd"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1265","DOI":"10.1007\/s00192-013-2090-2","article-title":"Seventeen years' follow-up of the tension-free vaginal tape procedure for female stress urinary incontinence","volume":"24","author":"CG Nilsson","year":"2013","journal-title":"Int Urogynecol J"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1311","DOI":"10.1001\/jama.300.11.1311","article-title":"Prevalence of symptomatic pelvic floor disorders in US women","volume":"300","author":"I Nygaard","year":"2008","journal-title":"JAMA"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1007\/s00192-021-05018-z","article-title":"International urogynecology consultation chapter 1 committee 2: Epidemiology of pelvic organ prolapse: prevalence, incidence, natural history, and service needs","volume":"33","author":"HW Brown","year":"2022","journal-title":"Int Urogynecol J"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1007\/s00120-019-01074-y","article-title":"[Use of synthetic slings and mesh implants in the treatment of female stress urinary incontinence and prolapse : Statement of the Working Group on Urological Functional Diagnostics\n          and Female Urology of the Academy of the German Society of Urology]","volume":"59","author":"K H\u00f6fner","year":"2020","journal-title":"Urologe A"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"e66","DOI":"10.1097\/AOG.0000000000001148","article-title":"Bulletin AP. 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Siegal","year":"2021","journal-title":"Urology"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"486","DOI":"10.1097\/spv.0000000000001196","article-title":"Trends in Performance of Anti-Incontinence Treatment at the Time of Pelvic Organ Prolapse Repair From 2011 to 2019","volume":"28","author":"GE Zemtsov","year":"2022","journal-title":"Urogynecology (Phila)"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1111\/ajo.12445","article-title":"Age-stratified trends in 20 years of stress incontinence surgery in Australia","volume":"56","author":"J Brown","year":"2016","journal-title":"Aust N Z J Obstet Gynaecol"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1016\/j.urology.2019.04.050","article-title":"Trends in Stress Urinary Incontinence Surgery at a Tertiary Center: Midurethral Sling Use Following the AUGS\/SUFU Position Statement","volume":"131","author":"R 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Pecchio","year":"2020","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"2544","DOI":"10.1002\/nau.24513","article-title":"What effect will the COVID-19 pandemic have on urogynecology services in the United Kingdom?","volume":"39","author":"TG Gray","year":"2020","journal-title":"Neurourol Urodyn"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1007\/s00192-020-04618-5","article-title":"Quality of life and sexual function after TVT surgery versus Bulkamid injection for primary stress urinary incontinence: 1\u00a0year results from a randomized clinical trial","volume":"32","author":"AM Itkonen Freitas","year":"2021","journal-title":"Int Urogynecol J"}],"container-title":["Geburtshilfe und 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