1
|
Sinha S, Yande S, Patel A, Vaze A, Sarkar K, Raina S, Agarwal MM, Vasudeva P, Khattar N, Madduri VKS, Mishra N, Jain A, Gupta M. The Urological Society of India survey on urinary incontinence practice patterns among urologists. Indian J Urol 2018; 34:202-210. [PMID: 30034131 PMCID: PMC6034410 DOI: 10.4103/iju.iju_85_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction: The Urological Society of India guidelines panel on urinary incontinence (UI) conducted a survey among its members to determine their practice patterns in the management of UI. The results of this survey are reported in this manuscript. Methods: An anonymous online survey was carried out among members of the USI to determine their practice patterns regarding UI using a predeveloped questionnaire on using SurveyMonkey®. A second 4-question randomized telephonic survey of the nonresponders was performed after closure of the online survey. Data were analyzed by R software 3.1.3 (P < 0.05 significant). Results: A total of 468 of 2109 (22.2%) members responded to the online survey. Nearly 97% were urologists, 74.8% were working at a private, and 39.4% were in an academic institution. Almost all were managing UI. 84.2% had local access to a urodynamics (UDS) facility. 85.8% would check postvoid residual urine for all the patients. Voiding diary, symptom scores, quality of life scores, pad test, Q-tip test, stress test, uroflow, and cystoscopy were ordered as part of evaluation by 86.0%, 49.8%, 24.4%, 22.0%, 6.0%, 71.8%, 69.2%, and 34.7%, respectively. 47.6% would order a UDS for patients with urgency UI who fail conservative treatment. 36.9% would get UDS prior to all stress UI surgery. Seventy-five percent would make a diagnosis of intrinsic sphincter deficiency. Solifenacin was the first choice for urgency UI in general and darifenacin was preferred in elderly. Botulinum was the first choice for refractory urgency UI. Midurethral sling was the commonest procedure for surgical management of SUI (95.1%). 147 of the 1641 non responders were randomly sampled telephonically. Telephonic respondents had similar access to UDS facility but had performed fewer lifetime number of post-prostatectomy incontinence (PPI) surgeries. Combining data from both surveys, total number of artificial sphincters and PPI surgeries ever performed by USI members was estimated at 375 and 718 respectively. Conclusion: This survey provides important new data and elicits critical differences in management practices based on demographics.
Collapse
Affiliation(s)
- Sanjay Sinha
- Department of Urology, Apollo Hospitals, Hyderabad, Telangana, India
| | - Shirish Yande
- Department of Urology, Ruby Hall Clinic, Pune, Maharashtra, India
| | - Anita Patel
- Department of Urology, Global Hospital and KEM Hospital, Mumbai, Maharashtra, India
| | - Ajit Vaze
- Department of Urology, Lilavati Hospital, Mumbai, Maharashtra, India
| | - Kalyan Sarkar
- Department of Urology, Vivekananda Institute, Kolkata, West Bengal, India
| | - Shailesh Raina
- Department of Urology, Jaslok Hospital, Mumbai, Maharashtra, India
| | - Mayank Mohan Agarwal
- Department of Urology, Aster Dr Ramesh Multispecialty Hospitals, Guntur, Andhra Pradesh, India
| | - Pawan Vasudeva
- Department of Urology, VM Medical College and Safdarjung Hospital, New Delhi, India
| | - Nikhil Khattar
- Department of Reconstructive and Female Urology, Medanta Hospital, Gurgaon, Haryana, India
| | - Vijay Kumar Sarma Madduri
- Department of Renal Transplant and Urology, Institute of Liver and Biliary Sciences, New Delhi, India
| | | | - Amita Jain
- Department of Urogynecology, Fortis Escorts Hospital, New Delhi, India
| | - Manu Gupta
- Department of Urology, Sir Ganga Ram Hospital, New Delhi, India
| |
Collapse
|
2
|
Rodrigues P, Hering F, Campagnari JC. Impact of Urodynamic Learning on the Management of Benign Prostatic Hyperplasia Issue on Young and Senior Urologists and Reasons to Attend a Voiding Dysfunction Course. Low Urin Tract Symptoms 2013; 6:41-5. [PMID: 26663499 DOI: 10.1111/luts.12017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Revised: 02/07/2013] [Accepted: 02/13/2013] [Indexed: 10/27/2022]
Abstract
OBJECTIVES The aims of this study were to compare the impact of urodynamic training on the young urologists after fellowship training as well as on senior urologists who attend regular courses on the management of benign prostatic hyperplasia (BPH) and their capacity to do and interpret urodynamic studies. METHODS Sixty-four consecutive young urologists admitted to fellowship program on voiding dysfunctions and 110 senior urologists attending to periodical meetings were interviewed before and after the 3-day-courses regarding their ability to set, interpret and do urodynamic studies. They were also questioned on the reasons that led them to attend the courses and how they use the new concepts to manage BPH. A rank of the used parameters to indicate transurethral resection of the prostate (TURP) in BPH patients were scored before and after the course. RESULTS Fellowship and senior urologists mainly attended the course because of lack of confidence and belief that this urological issue is too important to be disregarded. A significant portion of both groups do not trust third-party examiners. More than 90% of the urologists acquired confidence in interpreting, setting and were able to do the exam after the course. The majority of both groups believed urodynamic study was essential to manage BPH, disregarding volume as the main reason to operate on patients. Many outdated parameters became less important on the decision to operate. CONCLUSIONS Doctors exposed to intensive or long urodynamic training dramatically changed their perceptions on the utility of this tool and became more attentive it.
Collapse
Affiliation(s)
- Paulo Rodrigues
- Division of Neurourology and Voiding Disturbances, Beneficência Portuguesa Hospital of São Paulo and Department of Urology, Hospital Santa Helena of São Paulo, São Paulo, Brazil
| | - Flávio Hering
- Division of Neurourology and Voiding Disturbances, Beneficência Portuguesa Hospital of São Paulo and Department of Urology, Hospital Santa Helena of São Paulo, São Paulo, Brazil
| | - João Carlos Campagnari
- Division of Neurourology and Voiding Disturbances, Beneficência Portuguesa Hospital of São Paulo and Department of Urology, Hospital Santa Helena of São Paulo, São Paulo, Brazil
| |
Collapse
|
3
|
Denys P, Soler JM, Fatton B, Rischmann P, Yelnik A, Aegerter P, Saidji-Domingo NY, Chartier-Kastler E. Mise en évidence des différences de gestion des vessies neurologiques existantes entre urologues et médecins spécialisés en médecine physique et de réhabilitation : enquête réalisée auprès de 383 spécialistes. Presse Med 2012; 41:e599-608. [DOI: 10.1016/j.lpm.2011.09.035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2011] [Revised: 09/07/2011] [Accepted: 09/21/2011] [Indexed: 11/30/2022] Open
|
4
|
Denys P, Soler JM, Fatton B, Rischmann P, Yelnik A, Aegerter P, Saidji-Domingo NY, Chartier-Kastler E. [Management of neurogenic bladder patients in France: a survey carried out by the French-speaking neurourology study group (GENULF)]. Prog Urol 2012; 22:540-8. [PMID: 22732646 DOI: 10.1016/j.purol.2012.02.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2012] [Revised: 02/22/2012] [Accepted: 02/23/2012] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To design and run a survey aiming at investigating urologists' and physiatrists' clinical practices in France when managing neurogenic bladder patients. PATIENTS AND METHODS Three thousand one hundred and eighty questionnaires were sent to the members of four French societies involved in treating neurogenic bladder dysfunction. Questions were focused on consultations, clinical follow-up and patient management. RESULTS Two hundred and seventy-four urologists and 109 physiatrists completed the questionnaire. The frequency of systematic follow-up differed between urologists (6 months) and physiatrists (12 months). Upper urinary tract imaging and systematic urodynamic follow-up were usually performed yearly. The latter was carried out by 56% urologists and 83% physiatrists. Urinary retention was essentially treated by intermittent catheterization. Less than 15% of urologists and physiatrists were treating bacteriuria. Symptomatic urinary infections were treated for 11 to 12 days (men) and for 8 to 9 days (women). To treat their patients, both specialists used self-catheterization education and botulinum toxin A injections. CONCLUSION Our survey showed differences in approach between urologists and physiatrists in the management of patients with neurogenic bladder dysfunction. Their clinical practice was most of the time in line with national and international guidelines.
Collapse
Affiliation(s)
- P Denys
- Service de médecine physique et de réadaptation, hôpital Raymond-Poincaré, 92380 Garches, France.
| | | | | | | | | | | | | | | |
Collapse
|
5
|
Murray E, Lo B, Pollack L, Donelan K, Catania J, Lee K, Zapert K, Turner R. The impact of health information on the Internet on health care and the physician-patient relationship: national U.S. survey among 1.050 U.S. physicians. J Med Internet Res 2003; 5:e17. [PMID: 14517108 PMCID: PMC1550564 DOI: 10.2196/jmir.5.3.e17] [Citation(s) in RCA: 242] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2003] [Accepted: 07/27/2003] [Indexed: 11/29/2022] Open
Abstract
Background Public use of the Internet for health information is increasing but its effect on health care is unclear. We studied physicians' experience of patients looking for health information on the Internet and their perceptions of the impact of this information on the physician-patient relationship, health care, and workload. Methods Cross-sectional survey of a nationally-representative sample of United States physicians (1050 respondents; response rate 53%). Results Eighty-five percent of respondents had experienced a patient bringing Internet information to a visit. The quality of information was important: accurate, relevant information benefited, while inaccurate or irrelevant information harmed health care, health outcomes, and the physician-patient relationship. However, the physician's feeling that the patient was challenging his or her authority was the most consistent predictor of a perceived deterioration in the physician-patient relationship (OR = 14.9; 95% CI, 5.5-40.5), in the quality of health care (OR = 3.4; 95% CI, 1.1-10.9), or health outcomes (OR = 5.6; 95% CI, 1.7-18.7). Thirty-eight percent of physicians believed that the patient bringing in information made the visit less time efficient, particularly if the patient wanted something inappropriate (OR = 2.5; 95% CI, 1.5-4.4), or the physician felt challenged (OR = 3.6; 95% CI, 1.8-7.2). Conclusions The quality of information on the Internet is paramount: accurate relevant information is beneficial, while inaccurate information is harmful. Physicians appear to acquiesce to clinically-inappropriate requests generated by information from the Internet, either for fear of damaging the physician-patient relationship or because of the negative effect on time efficiency of not doing so. A minority of physicians feels challenged by patients bringing health information to the visit; reasons for this require further research.
Collapse
Affiliation(s)
- Elizabeth Murray
- Royal Free and University College School of Medicine at University College London, Department of Primary Care and Population Sciences, London, UK.
| | | | | | | | | | | | | | | |
Collapse
|