Surgery for recurrent stress urinary incontinence: surgeons’ and women’s views

The Three S study

Timescale: August 2014 - September 2015

Funder: Wellbeing of Women


Surgery for recurrent stress urinary incontinence: surgeons’ and women’s views. The Three S studyTreatment options for stress urinary incontinence include pelvic floor muscle training or surgery, typically something called a mid-urethral sling. The cure rate after a mid-urethral sling is 85% , but 1 woman in 7 remains incontinent or develops recurrence. There is no evidence to guide the decision about what procedure to offer these women. Options include a second mid-urethral sling of the same or different type, or an alternative operation such as colposuspension or fascial sling, both major operations with longer recovery time. A recent systematic review identified no randomised trials, indicating the need for an RCT (randomised control trial) in this area. Any such RCT must be relevant and acceptable to both patients and clinicians, comparing alternative procedures which are currently offered to women.

The research study

In this feasibility study we will conduct semi-structured interviews with women having continence surgery to explore their views, attitudes and acceptability of alternative surgical options. We will also explore the relevance to women of the potential outcome measures that could be used in an RCT. We will circulate an electronic survey to UK gynaecologists and urologists seeking their views and opinions about which of the alternative procedures are currently offered, and which would be suitable to compare in an RCT, using the Surgical Equipoise Scale. We will ask for the numbers of eligible women seen at each centre and whether individuals will be willing to recruit. A sample of responding surgeons will be interviewed by telephone to explore their views in more depth.

Research Team

Tincello DG, Armstrong N, Hilton P, Buckley B, Mayne CJ.

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