The vicissitudes of open and laparoscopic retropubic urethropexy for stress urinary incontinence in Taiwan

An 11-year nationwide analysis

Pei Yang Hsu, Cheng Yu Long, Yu Tung Huang, Kuan Hui Huang, Chao Hsiun Tang, Ming-Ping Wu

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objective: To characterize the changing trend and variables of either open or laparoscopic retropubic urethropexy (RPU) in treating female stress urinary incontinence (SUI) in Taiwan. Materials and methods: Using the National Health Insurance Research Database (NHIRD), a total of 8977 female patients with SUI during the period between 1997 and 2007 were identified. The differences in distribution of open and laparoscopic RPU in the context of different years, patient age, surgeon age and gender, and hospital accreditation level and ownership were examined using Chi-square tests. Results: An upward trend of annual RPU was found between 1997 (377 procedures per year) and 2004 (1060), followed by a downward trend between 2004 and 2007 (705). In the meantime, an upward trend of using laparoscopy for SUI was found between 1997 and 2002 (annual percentage change, APC = 24.86, p = 0.001), followed by a downward trend from 2002 to 2007 (APC = -41.88, p = 0.001), which was evidenced by joinpoint regression analysis. In year 2007, only 10 laparoscopic RPU procedures were performed. Patient age, surgeon age, hospital accreditation level, and ownership were shown to have statistically significant associations with the types of RPU chosen (all p values for the Chi-square tests were less than 0.0001). Surgeon gender was not associated with the choices of surgical types (p = 0.85). Conclusion: The vicissitudes of laparoscopic RPU, with an initial increase followed by a decrease around the year of 2002, happened during the past 11 years in Taiwan. The evolution of the surgical methods for SUI may affect the trend of the choices of RPU approaches significantly. The increased and decreased demands on laparoscopic RPU before and after the emergence of tension-free vaginal tape denote the need for more minimally invasive procedures. Nevertheless, the long-term value of novel surgical modalities for SUI is yet to be defined.

Original languageEnglish
Pages (from-to)22-26
Number of pages5
JournalGynecology and Minimally Invasive Therapy
Volume2
Issue number1
DOIs
Publication statusPublished - Feb 2013

Fingerprint

Stress Urinary Incontinence
Taiwan
Ownership
Accreditation
Chi-Square Distribution
Suburethral Slings
National Health Programs
Laparoscopy
Regression Analysis
Databases
Research
Surgeons

Keywords

  • Laparoscopy
  • Minimal invasive suburethral sling (MISS)
  • Retropubic urethropexy (RPU)
  • Stress urinary incontinence

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

The vicissitudes of open and laparoscopic retropubic urethropexy for stress urinary incontinence in Taiwan : An 11-year nationwide analysis. / Hsu, Pei Yang; Long, Cheng Yu; Huang, Yu Tung; Huang, Kuan Hui; Tang, Chao Hsiun; Wu, Ming-Ping.

In: Gynecology and Minimally Invasive Therapy, Vol. 2, No. 1, 02.2013, p. 22-26.

Research output: Contribution to journalArticle

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abstract = "Objective: To characterize the changing trend and variables of either open or laparoscopic retropubic urethropexy (RPU) in treating female stress urinary incontinence (SUI) in Taiwan. Materials and methods: Using the National Health Insurance Research Database (NHIRD), a total of 8977 female patients with SUI during the period between 1997 and 2007 were identified. The differences in distribution of open and laparoscopic RPU in the context of different years, patient age, surgeon age and gender, and hospital accreditation level and ownership were examined using Chi-square tests. Results: An upward trend of annual RPU was found between 1997 (377 procedures per year) and 2004 (1060), followed by a downward trend between 2004 and 2007 (705). In the meantime, an upward trend of using laparoscopy for SUI was found between 1997 and 2002 (annual percentage change, APC = 24.86, p = 0.001), followed by a downward trend from 2002 to 2007 (APC = -41.88, p = 0.001), which was evidenced by joinpoint regression analysis. In year 2007, only 10 laparoscopic RPU procedures were performed. Patient age, surgeon age, hospital accreditation level, and ownership were shown to have statistically significant associations with the types of RPU chosen (all p values for the Chi-square tests were less than 0.0001). Surgeon gender was not associated with the choices of surgical types (p = 0.85). Conclusion: The vicissitudes of laparoscopic RPU, with an initial increase followed by a decrease around the year of 2002, happened during the past 11 years in Taiwan. The evolution of the surgical methods for SUI may affect the trend of the choices of RPU approaches significantly. The increased and decreased demands on laparoscopic RPU before and after the emergence of tension-free vaginal tape denote the need for more minimally invasive procedures. Nevertheless, the long-term value of novel surgical modalities for SUI is yet to be defined.",
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AB - Objective: To characterize the changing trend and variables of either open or laparoscopic retropubic urethropexy (RPU) in treating female stress urinary incontinence (SUI) in Taiwan. Materials and methods: Using the National Health Insurance Research Database (NHIRD), a total of 8977 female patients with SUI during the period between 1997 and 2007 were identified. The differences in distribution of open and laparoscopic RPU in the context of different years, patient age, surgeon age and gender, and hospital accreditation level and ownership were examined using Chi-square tests. Results: An upward trend of annual RPU was found between 1997 (377 procedures per year) and 2004 (1060), followed by a downward trend between 2004 and 2007 (705). In the meantime, an upward trend of using laparoscopy for SUI was found between 1997 and 2002 (annual percentage change, APC = 24.86, p = 0.001), followed by a downward trend from 2002 to 2007 (APC = -41.88, p = 0.001), which was evidenced by joinpoint regression analysis. In year 2007, only 10 laparoscopic RPU procedures were performed. Patient age, surgeon age, hospital accreditation level, and ownership were shown to have statistically significant associations with the types of RPU chosen (all p values for the Chi-square tests were less than 0.0001). Surgeon gender was not associated with the choices of surgical types (p = 0.85). Conclusion: The vicissitudes of laparoscopic RPU, with an initial increase followed by a decrease around the year of 2002, happened during the past 11 years in Taiwan. The evolution of the surgical methods for SUI may affect the trend of the choices of RPU approaches significantly. The increased and decreased demands on laparoscopic RPU before and after the emergence of tension-free vaginal tape denote the need for more minimally invasive procedures. Nevertheless, the long-term value of novel surgical modalities for SUI is yet to be defined.

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