{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T07:55:17Z","timestamp":1777017317580,"version":"3.51.4"},"reference-count":26,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T00:00:00Z","timestamp":1739404800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In the late 2000s, mid\u2010urethral slings (MUS) emerged globally as the preferred surgical treatment for stress urinary incontinence (SUI). Despite their high safety and efficacy, through the late 2000s and 2010s, MUS became embroiled in widely publicised controversy surrounding mesh products used for pelvic organ prolapse.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To review recent trends in the surgical management of SUI in Australia in the context of recent medicolegal and media attention on transvaginal mesh devices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Data were obtained from the Australian Government Department of Human Services database from January 2007 to December 2023. Total procedure numbers for females \u2265\u200925\u2009years were retrieved for the following Medicare Benefits Schedule (MBS) item numbers: 35599 (MUS), 37044 (Burch colposuspension), 37043 (Stamey or similar), 37042 (autologous fascial sling) and 37339 (peri\u2010\/transurethral bulking agents).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 69\u2009145 MUS, 5749 Burch, 711 Stamey, 3243 fascial sling and 10\u2009798 bulking agent procedures were recorded during this period. Total procedures peaked at 6877 in 2010 and reached a low of 2627 in 2022, with a turning point in 2016. There was a 61.8% reduction in procedure numbers between these years. The decline in total SUI procedures directly reflects MUS numbers, which dropped by 80.4% between 2011 (5876 cases) and 2022 (1154 cases). This correlates with progressive restrictions and medicolegal events concerning transvaginal mesh during this time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There is a significant downtrend in overall surgical SUI management, especially MUS, being performed in Australia in recent years. The impact on surgical training and patient access to treatment options must be addressed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ajo.70005","type":"journal-article","created":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T05:46:00Z","timestamp":1739425560000},"page":"632-637","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Changing Trends in the Surgical Management of Stress Urinary Incontinence in Australia"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-8977-417X","authenticated-orcid":false,"given":"Charlotte","family":"Rook","sequence":"first","affiliation":[{"name":"The University of Sydney Northern Clinical School  Sydney New South Wales Australia"},{"name":"Centre for Advanced Reproductive Endosurgery (Sydney CARE)  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan","family":"Lam","sequence":"additional","affiliation":[{"name":"The University of Sydney Northern Clinical School  Sydney New South Wales Australia"},{"name":"Centre for Advanced Reproductive Endosurgery (Sydney CARE)  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,2,13]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2000.tb11669.x"},{"issue":"3","key":"e_1_2_7_3_1","first-page":"S3","article-title":"The Definition, Prevalence, and Risk Factors for Stress Urinary Incontinence","volume":"6","author":"Luber K. M.","year":"2004","journal-title":"Revista de Urolog\u00eda"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.23905"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(16)36367-0"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1089\/lps.1991.1.169"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01902378"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2016.04.018"},{"key":"e_1_2_7_9_1","article-title":"Minimally Invasive Synthetic Suburethral Sling Operations for Stress Urinary Incontinence in Women","volume":"4","author":"Ogah J.","year":"2009","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrurol.2012.243"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.2010.01217.x"},{"key":"e_1_2_7_12_1","unstructured":"D. G.SchultzandCenter for Devices and Radiological Health (CDRH) Food and Drug Administration (USA) \u201cUS FDA Public Health Notification: Serious Complications Associated With Transvaginal Placement of Surgical Mesh in Repair of Pelvic Organ Prolapse and Stress Urinary Incontinence \u201d(2008) https:\/\/www.govinfo.gov\/content\/pkg\/USCOURTS\u2010ca4\u201015\u201001454\/pdf\/USCOURTS\u2010ca4\u201015\u201001454\u20101.pdf."},{"key":"e_1_2_7_13_1","unstructured":"USA Food and Drug Administration (FDA)andCentre for Devices and Radiological Health (CDRH) \u201cUrogynaecological Surgical Mesh: Update on the Safety and Effectiveness of Transvaginal Placement for Pelvic Organ Prolapse \u201d(2011) https:\/\/www.fda.gov\/files\/medical%20devices\/published\/Urogynecologic\u2010Surgical\u2010Mesh\u2010\u2010Update\u2010on\u2010the\u2010Safety\u2010and\u2010Effectiveness\u2010of\u2010Transvaginal\u2010Placement\u2010for\u2010Pelvic\u2010Organ\u2010Prolapse\u2010%28July\u20102011%29.pdf."},{"key":"e_1_2_7_14_1","unstructured":"Australian Government Department of Health and Aged Care Therapeutic Goods Administration (TGA) \u201cAbout Transvaginal Surgical Mesh Devices: TGA \u201d(2023) https:\/\/www.tga.gov.au\/products\/urogynaecological\u2010transvaginal\u2010surgical\u2010mesh\u2010hub\/about\u2010transvaginal\u2010surgical\u2010mesh\u2010devices."},{"key":"e_1_2_7_15_1","unstructured":"Commonwealth of Australia Senate Community Affairs References Committee \u201cTransvaginal Mesh Implants and Related Matters \u201d(2017) 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https:\/\/www.smh.com.au\/national\/johnson\u2010and\u2010johnson\u2010lose\u2010pelvic\u2010mesh\u2010case\u2010to\u2010women\u2010in\u2010landmark\u2010judgment\u201020191121\u2010p53coe.html."},{"key":"e_1_2_7_18_1","unstructured":"Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) \u201cClinical Guidance Statement\u2014Position Statement on Midurethral Slings: RANZCOG \u201d(2020) https:\/\/ranzcog.edu.au\/wp\u2010content\/uploads\/Position\u2010Statement\u2010Midurethral\u2010Slings.pdf."},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318230b1f4"},{"key":"e_1_2_7_20_1","unstructured":"U.S. Food and Drug Administration (FDA) \u201cFDA Strengthens Requirements for Surgical Mesh for the Transvaginal Repair of Pelvic Organ Prolapse to Address Safety Risks: FDA \u201d(2016) 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Johnson Reaches $300\u2009m Settlement Over Pelvic Mesh Implants \u201dThe Guardian (2022) https:\/\/www.theguardian.com\/business\/2022\/sep\/12\/johnson\u2010johnson\u2010reaches\u2010300m\u2010settlement\u2010over\u2010pelvic\u2010mesh\u2010implants."},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11934-022-01099-5"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2018.10.003"},{"key":"e_1_2_7_26_1","volume-title":"Admitted Patient Care 2017\u201318: Australian Hospital Statistics","author":"Australian Institute of Health and Welfare","year":"2019"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.15302"}],"container-title":["Australian and New Zealand Journal of Obstetrics and Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajo.70005","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T15:29:16Z","timestamp":1767022156000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/ajo.70005"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,13]]},"references-count":26,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1111\/ajo.70005"],"URL":"https:\/\/doi.org\/10.1111\/ajo.70005","archive":["Portico"],"relation":{},"ISSN":["0004-8666","1479-828X"],"issn-type":[{"value":"0004-8666","type":"print"},{"value":"1479-828X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,13]]},"assertion":[{"value":"2024-06-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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