National BSUG audit of stress urinary incontinence surgery in England

Int Urogynecol J. 2019 Aug;30(8):1337-1341. doi: 10.1007/s00192-018-3705-4. Epub 2018 Jul 11.


Introduction and hypothesis: The aim of the British Society of Urogynaecology (BSUG) 2013 audit for stress urinary incontinence (SUI) surgery was to conduct a national clinical audit looking at the intra- and postoperative complications and provide outcomes for these procedures. This audit was supported by the Healthcare Quality Improvement Partnership (HQIP) and National Health Service (NHS) England.

Methods: Data were collected for all continence procedures performed in 2013 through the BSUG database. All clinicians in England performing SUI surgery were invited to submit data to a central database. Outcomes data for the different continence procedures were collected and included intraoperative and postoperative complications and the change in continence scores at postoperative follow-up Changing trends in stress incontinence surgery were also assessed.

Results: We recorded 4993 urinary incontinence procedures from 177 consultants at 110 centres in England: 94.6% were midurethral slings; 86.7% (4331) were submitted by BSUG members with the remaining 13.3% submitted by non-BSUG members. Postoperative follow-up data were available for 3983 (80%) patients: 92.3% (3676) were very much better/much better postoperatively, and 4806 (96.3%) proceeded with no reported complications. There were 187 cases (3.7%) in which a perioperative complication was recorded. Pain persisting >30 days was reported in 1.9% of all patients.

Conclusions: Surgery for SUI has good outcomes in the short term. Midurethral synthetic slings have been shown to be safe and effective as a treatment option, with >90% being very much/much better at their postoperative follow-up.

Keywords: Audit; Autologous fascial sling; Colposuspension; Midurethral sling; Stress urinary incontinence; Urethral bulking.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Clinical Audit
  • England
  • Gynecology
  • Humans
  • Intraoperative Complications / epidemiology*
  • Middle Aged
  • Postoperative Complications / epidemiology*
  • Societies, Medical
  • Urinary Incontinence, Stress / surgery*
  • Urologic Surgical Procedures / standards
  • Urology
  • Young Adult