Urogynecology (Hagerstown, Md.)最新文献

{"title":"Effect of Older Age on Postoperative Urinary Retention After Prolapse Surgery.","authors":"Kristiana B McLarty, Stephanie W Zuo, Kristina J Warner, Steven R Orris, Tien C Nguyen, Nicole A Meckes, Brigid S Mumford, Kavya Bellam, Richael Rayen, Mary F Ackenbom","doi":"10.1097/SPV.0000000000001631","DOIUrl":"10.1097/SPV.0000000000001631","url":null,"abstract":"<p><strong>Importance: </strong>Postoperative urinary retention (POUR) is common after reconstructive pelvic surgery. Little is known about the relationship between older age (≥70 years) and POUR after pelvic organ prolapse surgery.</p><p><strong>Objectives: </strong>We aimed to investigate the relationship between age ≥70 years and POUR. Secondarily, we aimed to determine if duration of urinary catheterization differed by age in women with POUR.</p><p><strong>Study design: </strong>This was a secondary analysis of a dual-center retrospective study on perioperative adverse events in biologic females aged ≥61 years undergoing prolapse surgery. The primary outcome was POUR, defined as a failed retrograde voiding trial requiring bladder catheterization. The secondary outcome was duration of temporary bladder catheterization. We developed a stepwise multivariable logistic regression model, which included relevant variables with P < 0.10 on univariate analyses and a forced age variable.</p><p><strong>Results: </strong>In this cohort of 2,665 women, mean ± standard deviation age was 71.2 ± 6.7 years, and 54.6% were ≥70 years, POUR occurred in 830 (31.1%) patients. Women with POUR had a lower body mass index and were more likely to have undergone a vaginal prolapse surgery and concomitant hysterectomy/incontinence procedure ( P < 0.05). They had higher estimated blood loss (75 vs 50 mL, P < 0.001). On multivariable logistic regression, age ≥70 years was not associated with POUR (adjusted odds ratio 1.02, 95% CI [0.83-1.26]). Age ≥70 years was associated with longer duration of catheterization (5 vs 4 days, P < 0.01).</p><p><strong>Conclusion: </strong>Age was not associated with POUR when controlling for other clinical factors (body mass index, surgical approach, concomitant hysterectomy/incontinence surgery, and estimated blood loss). These factors may affect POUR in older women and should be considered in perioperative management.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"390-396"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Symptom Documentation Before Antibiotics for Recurrent Urinary Tract Infections.","authors":"Alexandra Kuzma, Elizabeth Critchlow, Nathanael Koelper, Surbhi Agrawal, Lauren Dutcher, Lily Arya","doi":"10.1097/SPV.0000000000001626","DOIUrl":"10.1097/SPV.0000000000001626","url":null,"abstract":"<p><strong>Importance: </strong>Documentation of symptoms in the medical record before prescribing antibiotics for urinary tract infection (UTI) could promote antibiotic stewardship.</p><p><strong>Objective: </strong>The aim of this study was to describe the number and type of symptoms documented across specialties during encounters where an antibiotic was prescribed to older women with recurrent UTI.</p><p><strong>Study design: </strong>We conducted a retrospective cohort study of women aged 65 years or older with a diagnosis of recurrent UTI. Patients were included if they had been prescribed an antibiotic for UTI at least twice in 6 months or 3 times in 1 year. Data on number and type of symptoms and urine culture results were extracted and compared across encounters and specialties.</p><p><strong>Results: </strong>A total of 454 encounters from 175 patients were analyzed. The majority of encounters were in primary care (61.8%), followed by urology/urogynecology (24%), obstetrics and gynecology (9.2%), and emergency department/urgent care (4.8%). The median number of UTI-specific symptoms recorded across specialties was 1 (interquartile range, 0-2) and declined in subsequent encounters. The number of UTI-specific symptoms documented was none in 25%, 1 in 26%, and 2 or more in 49% of encounters. Of the 337 encounters with positive cultures, 19% had no documented UTI-specific symptoms and 9% had no documented symptoms of any kind.</p><p><strong>Conclusions: </strong>Documentation of urinary symptoms during encounters where antibiotics are prescribed is sparse across specialties for older patients with recurrent UTI. The gap in care identifies an opportunity for improving antibiotic stewardship through improved documentation of urinary symptoms.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"369-376"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sacral Neuromodulation Reprogramming Rates: Understanding Office-Based Requirement.","authors":"Helen Query, Tyler Morgan, Adam P Klausner, Linda S Burkett","doi":"10.1097/SPV.0000000000001635","DOIUrl":"10.1097/SPV.0000000000001635","url":null,"abstract":"<p><strong>Importance: </strong>Sacral neuromodulation (SNM) is a procedure with the advantage of reprogramming for discomfort or inadequate symptom control.</p><p><strong>Objectives: </strong>The aims of this study were to investigate the rates of office-based SNM programming in a large multisite cohort and to examine differences based on implantation indication.</p><p><strong>Study design: </strong>The TriNetX database was utilized for retrospective cohort comparison using International Classification of Diseases, Tenth Revision, and Current Procedural Terminology (CPT) codes. Cohort selection included female adults with a diagnosis of urinary retention, urgency urinary incontinence, and/or fecal incontinence (FI) at time of implantation. The primary outcome was the rate of SNM reprogramming CPT per individual from 6 weeks to 5 years postimplantation. Secondary outcomes included demographic comparisons, incidence, and survival curves for patients with SNM reprogramming identified with CPT codes. Further comparisons were completed between implantation diagnoses of grouped urinary (urgency and retention) versus fecal indications.</p><p><strong>Results: </strong>A total of 9,501 patients meet inclusion criteria with a mean of age 62.1 ± 14.9 years (range, 18-90). Office-based SNM reprogramming was identified in 31.5%. The probability of never having reprogramming at 5 years was 52.5%. The mean number of reprogramming sessions was 2.5 ± 2.1. Approximately half (48%) of the patients with FI also had a diagnosis of urgency urinary incontinence, and approximately 25% had urinary retention. The probability of never having reprogramming was 55% and higher in patients with a fecal incontinence indication than those with only urinary indications at 50%, P < 0.001.</p><p><strong>Conclusions: </strong>Office-based SNM reprogramming occurs in 31.5% of patients with implants, and rates are likely underreported. Patients with any FI diagnosis have a higher risk of requiring reprogramming.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"444-448"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Purported Bladder Irritant Intake in Women With Urgency Urinary Incontinence.","authors":"Barbara Ha, Lisa R Yanek, Bryna J Harrington, Joan L Blomquist, Chi Chiung Grace Chen, Danielle Patterson, Victoria L Handa","doi":"10.1097/SPV.0000000000001652","DOIUrl":"10.1097/SPV.0000000000001652","url":null,"abstract":"<p><strong>Importance: </strong>Patients with urgency urinary incontinence are often recommended to avoid bladder irritants, but there is a lack of evidence for this.</p><p><strong>Objective: </strong>The aim of the study was to compare consumption of purported bladder irritants between women with and without urgency urinary incontinence.</p><p><strong>Study design: </strong>We performed a case-control study of nonpregnant females aged ≥20 years using the National Health and Nutrition Examination Survey, 2007-2020. Cases were defined as participants with moderate, severe, or very severe urgency urinary incontinence without stress urinary incontinence, measured with the Sandvik Incontinence Severity Index. Controls were defined as those without urgency urinary incontinence. The exposures of interest were 6 bladder irritants listed by the National Institute of Diabetes and Digestive and Kidney Diseases: (1) alcohol; (2) spicy foods; (3) chocolate; (4) artificial sweeteners; (5) caffeinated, carbonated, and citrus beverages; and (6) high-acid foods. Weighted multivariable logistic regression analysis was used to determine independent associations between each irritant and urgency urinary incontinence.</p><p><strong>Results: </strong>Overall, this study included 651 cases with urgency urinary incontinence (6.8%) and 8,890 controls (93.2%). More cases reported consuming caffeinated, carbonated, and citrus beverages (53.8% vs 47.1%, P = 0.01) and high-acid foods (50.3% vs 44.3%, P = 0.02). In multivariable analysis, the odds of urgency urinary incontinence were increased significantly with intake of caffeinated, carbonated, and citrus beverages (odds ratio 1.37, 95% confidence interval 1.09-1.73) and high-acid foods (odds ratio 1.29, 95% confidence interval 1.03-1.62).</p><p><strong>Conclusions: </strong>In this case-control study of community-dwelling adult females, urgency urinary incontinence was associated with consumption of caffeinated, carbonated, and citrus beverages and high-acid foods. Adequately powered prospective trials are needed to further investigate the effects of these foods and beverages on urgency urinary incontinence to guide clinical practice.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"352-360"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urogynecology Research Is Underrepresented in Top Obstetrics and Gynecology Journals.","authors":"Monica Saleeb, Sruthi Muluk, Nicole Wood, Elisabeth Sappenfield, Elena Tunitsky-Bitton","doi":"10.1097/SPV.0000000000001651","DOIUrl":"10.1097/SPV.0000000000001651","url":null,"abstract":"<p><strong>Importance: </strong>Patients with urogynecologic conditions commonly present to general gynecology practices. Consequently, it is imperative that journals for obstetrics and gynecology (OBGYN) represent topics pertinent to comprehensive women's health, including urogynecology topics.</p><p><strong>Objective: </strong>The aim of the study was to analyze the prevalence of urogynecology research compared to other topics in top OBGYN journals.</p><p><strong>Study design: </strong>This was a retrospective review of all papers published in top OBGYN-focused journals from 2000 to 2023. The publicly available PubMed package in R was used to extract papers. Stata, a statistical software package, was used to develop an algorithm searching for key words concerning urogynecology, obstetrics, benign gynecology, gynecologic oncology, and reproductive endocrinology and infertility. The algorithm was tested and cross-validated via manual review of papers published in 1999 to determine whether identified key words were accurate in determining paper content. The algorithm was modified with additional key words and revalidated based on this initial analysis.</p><p><strong>Results: </strong>Validation of the algorithm using all 1999 publications from several top OBGYN journals found a 93.48% accuracy for correct identification and classification of papers. Analysis was performed for 81,174 articles between 2000 and 2023. An average of 6.64% of publications focused on urogynecology topics. In contrast, 41.42% of publications concerned obstetrics, 33.9% on other benign gynecology, 41.9% on gynecologic oncology, and 24.7% on reproductive endocrinology and infertility.</p><p><strong>Conclusions: </strong>This study reveals consistent underrepresentation of urogynecology topics in leading OBGYN journals. Given that generalist gynecologists may not subscribe to subspecialty journals, this study underscores the need for the inclusion of urogynecologic research in OBGYN journals.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"428-435"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Diversity, Equity and Inclusion Statements of Urogynecology Fellowships.","authors":"Nicole Jenkins, Qilin Cao, Gregory Vurture, Scott W Smilen","doi":"10.1097/SPV.0000000000001623","DOIUrl":"10.1097/SPV.0000000000001623","url":null,"abstract":"<p><strong>Importance: </strong>The Accreditation Council for Graduate Medical Education (ACGME) has aimed to increase diversity among the physician workforce. Prospective applicants utilize websites to identify programs that share a commitment to equity and inclusion. Published statements of Diversity, Equity, and Inclusion (DEI) demonstrate a fellowship program's recognition of the importance of improving diversity in health care and medical education.</p><p><strong>Objective: </strong>The aim of the study was to assess the utilization of DEI statements published on urogynecology and reconstructive pelvic surgery (URPS) fellowship program websites.</p><p><strong>Study design: </strong>All ACGME accredited URPS fellowship websites in July 2023 were reviewed for presence of a DEI statement as a primary outcome. Website content was then compared across geographical regions (Northeast, Mid-Atlantic, Midwest, South, and West).</p><p><strong>Results: </strong>Seventy-two URPS programs had a dedicated website for review. Nine (12.5%) URPS programs had a published diversity statement. There were no statistical differences in the presence of a statement in URPS fellowships based on core-surgical speciality or geographic region.</p><p><strong>Conclusions: </strong>A majority of URPS programs lack a DEI statement (87.5%) demonstrating an area for improvement. With an increasingly diverse patient population, the recruitment of a diverse pool of physician applicants is more crucial than ever. By advocating for transparency, URPS fellowship programs can foster an environment that nurtures a physician workforce better equipped to provide culturally inclusive health care.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"449-453"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142831168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors for Wound Complications After Obstetric Anal Sphincter Injury.","authors":"Nicole A Meckes, Coralee T Toal, Li Wang, Lauren E Giugale","doi":"10.1097/SPV.0000000000001642","DOIUrl":"10.1097/SPV.0000000000001642","url":null,"abstract":"<p><strong>Importance: </strong>Wound complications after obstetric anal sphincter injury (OASI) can amplify morbidity and affect quality of life.</p><p><strong>Objective: </strong>The objective of this study was to evaluate for characteristics associated with wound complications after OASI.</p><p><strong>Study design: </strong>This was a retrospective cohort study of patients with an OASI who were evaluated in a postpartum pelvic floor healing clinic between November 1, 2020, and May 16, 2023. Our primary outcome was to identify factors associated with wound complications (wound infection or breakdown, antibiotic treatment, or surgical intervention). We hypothesized that operative vaginal delivery would be associated with wound complications and that peripartum antibiotics would be protective. Statistical analyses included t tests, chi-square test, Fisher exact test, and multivariable logistic regression.</p><p><strong>Results: </strong>Of 332 patients with an OASI, 74 (22.3%) experienced a wound complication. There were 31 (9.3%) wound infections and 62 (18.7%) wound breakdowns; 50 (15.1%) patients received additional antibiotics, and 20 (6.0%) underwent additional surgical intervention. On univariate analysis, those with wound complications were older (31.9 vs 30.6 years, P = 0.01) and more likely to have had an episiotomy (23.0% vs 12.5%, P = 0.03). On multivariable logistic regression, older maternal age was associated with wound complication (odds ratio, 1.1, 95% CI, 1.01-1.13, P = 0.03), and peripartum antibiotics were associated with decreased odds of wound complication (odds ratio, 0.57, 95% CI, 0.33-0.97, P = 0.04). Patients with wound complications were more likely to undergo in-office procedures ( P < 0.001) and report postpartum pain ( P < 0.001), urinary incontinence ( P = 0.02), fecal urgency ( P = 0.02), and other symptoms ( P = 0.04).</p><p><strong>Conclusions: </strong>Older maternal age was associated with wound complications after OASI, while peripartum antibiotics were protective. Patients with wound complications were more likely to report symptoms of pelvic floor disorders.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"405-411"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing the Laparoscopic Vecchietti Procedure: Tips and Tricks.","authors":"Annika Sinha, Abbigail Woll, Cassandra K Kisby","doi":"10.1097/SPV.0000000000001613","DOIUrl":"10.1097/SPV.0000000000001613","url":null,"abstract":"<p><strong>Background: </strong>The Vecchietti procedure is a staged procedure that, through use of an acrylic olive, allows for expedited traction and dilation to create a neovagina in patients with congenital vaginal agenesis. Although the steps are fairly standardized for the laparoscopic Vecchietti procedure, we have appreciated specific nuances in technique that have optimized our surgical approach and efficiency.</p><p><strong>Case: </strong>We present a case of congenital vaginal agenesis in a genetically female patient who completed neovaginal creation using the laparoscopic Vecchietti technique. During this case, we review each step of the procedure and offer technical strategies to enhance efficiency and effectiveness in the operating room. We also describe these specific preoperative, intraoperative, and postoperative considerations in a video.</p><p><strong>Conclusions: </strong>This optimized Vecchietti procedure, or traction vaginoplasty, is an excellent option for neovagina creation in those patients with vaginal agenesis. With the use of our techniques, we have had successful cosmetic and functional outcomes.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"465-468"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supplemental Lidocaine Patches Prior to Percutaneous Nerve Evaluation, a Randomized Trial.","authors":"Rodger W Rothenberger, Taylen Henry, Laurel Carbone, Jeremy T Gaskins, Ankita Gupta, Sean Francis, Stacy M Lenger","doi":"10.1097/SPV.0000000000001624","DOIUrl":"10.1097/SPV.0000000000001624","url":null,"abstract":"<p><strong>Importance: </strong>Improving patient comfort during percutaneous nerve evaluation (PNE), a trial procedure for sacral neuromodulation, is essential.</p><p><strong>Objective: </strong>The aim of the study was to determine whether the use of a lidocaine patch (LP) prior to PNE procedure improves the pain associated with PNE.</p><p><strong>Study design: </strong>This double-masked, randomized controlled trial compared a 4% LP to placebo patch (PP) immediately prior to PNE. Female patients ≥18 years of age were included if they were undergoing an office PNE, performed bilaterally and without fluoroscopy, for any indication. Either a lidocaine or placebo patch was placed over the sacrum 30 minutes prior to PNE. Additional local anesthesia with 2% lidocaine without epinephrine was administered per surgeon discretion. All patients received some volume of injectable lidocaine with their procedures. Secondary outcomes included volume of injectable lidocaine used, progression to a permanent implant, amplitude of perineal sensation, and patient satisfaction.</p><p><strong>Results: </strong>Thirty-nine women were enrolled, with 20 receiving LP and 19 patients receiving PP. Lower 100-mm visual analog scale pain score was seen in the LP group (45 ± 17 with LP vs 61 ± 21 with PP, P = 0.018). This difference was statistically and clinically significantly different between groups. The total injectable lidocaine, patient satisfaction, and progression to permanent implant were similar between groups.</p><p><strong>Conclusions: </strong>Patients experienced clinically and statistically significantly less pain at the time of PNE with a preprocedural LP when compared to placebo, despite similar use of local anesthetic. Satisfaction rates were high among all patients.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"377-383"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rising Rates of Urethral Bulking: A Retrospective Study of a National Database.","authors":"Taylor Whitaker, Samantha DeAndrade, K Marie Douglass, Tajnoos Yazdany","doi":"10.1097/SPV.0000000000001655","DOIUrl":"10.1097/SPV.0000000000001655","url":null,"abstract":"<p><strong>Importance: </strong>Stress urinary incontinence (SUI) affects approximately 50% of women. There are limited data regarding trends in management as treatment options have changed.</p><p><strong>Objective: </strong>This study aimed to analyze trends in the surgical management of SUI, including slings and urethral bulking, from 2012 to 2022.</p><p><strong>Study design: </strong>Patients from the American College of Surgeons National Surgical Quality Improvement Program database who had undergone a sling or urethral bulking procedure were identified by Current Procedural Terminology code. Descriptive statistics and independent paired t tests were performed.</p><p><strong>Results: </strong>A total of 81,657 patients received either slings or urethral bulking from 2012 to 2022. The number of slings performed peaked in 2017, decreased in 2020, and has subsequently increased. The rate of urethral bulking increased from 2019 to 2022. The average age patients who received urethral bulking was 64 years versus 56 years for sling patients ( P < 0.05). These patients were more likely to be American Society of Anesthesiology class III compared to those receiving slings (39% vs 25%, respectively, P < 0.05). Readmission and reoperation rates were not statistically different. Less invasive procedures were more likely to be performed concurrently with bulking.</p><p><strong>Conclusions: </strong>Sling placement is the most common surgical procedure for SUI but it decreased in 2020, likely due to COVID-19-related delays, and has not yet returned to prepandemic levels. Urethral bulking has become more common, possibly due to new agents available in U.S. markets. Patients who received urethral bulking were more likely to be older, have severe systemic disease, and underwent a less invasive concurrent procedure. Further research is needed to understand these trends.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"337-343"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}