{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T13:15:59Z","timestamp":1784207759007,"version":"3.55.0"},"reference-count":18,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T00:00:00Z","timestamp":1784160000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To delineate the surgical preferences of gynecologists in the management of primary stress urinary incontinence (SUI) and to explore the extent to which clinical experience, ingrained surgical habits, and procedural volume shape these therapeutic decisions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A national, web-based cross-sectional survey was distributed among practicing gynecologists across Turkey during the 2021 calendar year. Responses from 103 clinicians were analyzed. The questionnaire captured demographic profiles, operative case volumes, frequency of diagnostic laparoscopy, intraoperative cystoscopy practices, and the preferred surgical approach for primary SUI. Respondents were stratified into two cohorts: those favoring a vaginal sling procedure (encompassing TVT, TOT, or mini-sling techniques) and those opting for laparoscopic suspension (L\/S), specifically laparoscopic colposuspension. Statistical computations were performed using IBM SPSS version 20.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A clear majority of respondents (87.1%) gravitated toward vaginal sling techniques, while laparoscopic suspension was the preferred approach for 12.9%. Notably, surgeons favoring the L\/S route demonstrated a significantly higher annual volume of open Burch colposuspension experience (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.041). The propensity for L\/S was markedly diminished among clinicians who routinely perform intraoperative cystoscopy (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.023). The overall distribution of annual diagnostic laparoscopy volume categories differed between the two surgical groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.039), with the 5\u201320 cases category tending to be more frequent among surgeons who favored laparoscopic suspension. While no post-hoc pairwise comparisons were performed and the finding should be regarded as descriptive, it does suggest that a moderate, sustained engagement with laparoscopic surgery. No statistically significant intergroup variations were observed regarding age, years in practice, institutional setting, or geographic region.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The choice of surgical intervention for primary stress urinary incontinence extends beyond strict adherence to clinical guidelines; it remains intimately tied to the surgeon's individual technical repertoire and prior operative exposure. A background in advanced laparoscopy and the imprint of early surgical training emerge as potent determinants in the selection between retropubic suspension and sling-based therapies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1871350","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T12:44:56Z","timestamp":1784205896000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Surgical decision-making for primary stress urinary incontinence: insights from a nationwide survey of gynecologists in Turkey"],"prefix":"10.3389","volume":"13","author":[{"given":"\u0130lyas","family":"Turan","sequence":"first","affiliation":[{"name":"Department of Gynecologic Oncology, Batman Training and Research Hospital","place":["Batman, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d6zg\u00fcr Ozan","family":"Ceylan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Medical Park Izmir Hospital","place":["Izmir, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erhan","family":"Okuyan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Private Zilan Hospital","place":["Batman, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ebru","family":"Erdemo\u011flu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Isparta City Hospital","place":["Isparta, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,16]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","author":"Haylen","year":"","DOI":"10.1002\/nau.20798"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1091","DOI":"10.1097\/JU.0000000000003435","article-title":"Updates to surgical treatment of female stress urinary incontinence (SUI):aUA\/SUFUGuideline (2023)","volume":"209","author":"Kobashi","year":"2023","journal-title":"J Urol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1016\/j.eururo.2010.04.022","article-title":"Updated systematic review and meta-analysis of the comparative data on colposuspensions, pubovaginal slings, and midurethral tapes in thesurgical treatmentoffemale stress urinary incontinence","volume":"58","author":"Novara","year":"2010","journal-title":"Eur Urol"},{"key":"B4","article-title":"Urinary Incontinence and Pelvic Organ Prolapse in Women: Management","year":""},{"key":"B5","doi-asserted-by":"publisher","first-page":"455","DOI":"10.1017\/S0266462304001357","article-title":"Cost effectiveness of tension-free vaginal tape for the surgical management of female stress incontinence","volume":"20","author":"Kilonzo","year":"2004","journal-title":"Int J Technol Assess Health Care"},{"key":"B6","doi-asserted-by":"publisher","first-page":"2143","DOI":"10.1056\/NEJMoa070416","article-title":"Burch colposuspension versus fascial sling to reduce urinary stress incontinence","volume":"356","author":"Albo","year":"2007","journal-title":"N Engl J Med"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD006375.pub3","article-title":"Mid-urethral sling operations for stress urinary incontinence in women","author":"Ford","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"B8","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1016\/j.urology.2012.10.087","article-title":"Trends in the surgical management of stress urinary incontinence among female medicare beneficiaries, 2002\u20132007","volume":"82","author":"Rogo-Gupta","year":"2013","journal-title":"Urology"},{"key":"B9","doi-asserted-by":"publisher","first-page":"579","DOI":"10.1002\/ijgo.14418","article-title":"Counseling for stress urinaryincontinenceinthe eraof adversepublicityaround meshusage:results from a large-sample global survey","volume":"160","author":"Zilberlicht","year":"2023","journal-title":"Int J Gynaecol Obstet"},{"key":"B10","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1016\/j.ejogrb.2025.03.049","article-title":"European Urogynaecological association position statement: implantable devices for female stress incontinence surgery","volume":"309","author":"Ruffolo","year":"2025","journal-title":"Eur J ObstetGynecolReprod Biol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"565","DOI":"10.1007\/s00192-015-2853-z","article-title":"The \u201clearning curve\u201d for retropubic mid-urethral sling procedures: a retrospective cohort study","volume":"27","author":"Hilton","year":"2016","journal-title":"Int Urogynecol J"},{"key":"B12","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1016\/j.urology.2025.09.023","article-title":"Trends in urogynecologic and reconstructive pelvic SurgeryAmong early-career urologists: analysis of American board of urology case logs from 2009 to 2020","volume":"207","author":"Huang","year":"2026","journal-title":"Urology"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1182","DOI":"10.3346\/jkms.2009.24.6.1182","article-title":"Long-term results of laparoscopic burch colposuspension for stress urinary incontinence in women","volume":"24","author":"Hong","year":"2009","journal-title":"J Korean Med Sci"},{"key":"B14","doi-asserted-by":"publisher","first-page":"e83815","DOI":"10.7759\/cureus.83815","article-title":"Evaluating surgical trends and outcomes in stress urinary incontinence: aClinical audit at a district general hospital","volume":"17","author":"Kaur","year":"2025","journal-title":"Cureus"},{"key":"B15","year":""},{"key":"B16","doi-asserted-by":"publisher","first-page":"1485","DOI":"10.1007\/s11845-025-03986-5","article-title":"Attitudestowards stressurinaryincontinencesurgery inIreland:navigating the pause on mid-urethral sling use","volume":"194","author":"Rotem","year":"2025","journal-title":"Ir J Med Sci"},{"key":"B17","doi-asserted-by":"publisher","first-page":"738","DOI":"10.1016\/j.jmig.2024.05.007","article-title":"Randomized trial of single-incision midurethral sling and laparoscopic burch colposuspension: postoperative surgical outcomes and complications","volume":"31","author":"Yilmaz","year":"2024","journal-title":"J Minim Invasive Gynecol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"567","DOI":"10.1016\/j.eururo.2017.04.026","article-title":"Updated systematic review and meta-analysis of the comparative data on colposuspensions, pubovaginal slings, and midurethral Tapes in the surgical treatment of female stress urinary incontinence","volume":"72","author":"Fusco","year":"2017","journal-title":"Eur Urol"}],"container-title":["Frontiers in 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