Women's treatment preferences for stress urinary incontinence - physiotherapy or surgery

Patient choice is important in choosing appropriate treatments. We aimed to determine patient treatment preferences for urodynamic stress incontinence and reasons for particular preferences. In a survey, based in three urogynaecology departments in two countries, women diagnosed with urodynamic stress incontinence were given: 1) a questionnaire eliciting current knowledge of available urodynamic stress incontinence treatments; 2) information sheets describing pelvic floor muscle training by physiotherapists, the tension-free vaginal tape, and open colposuspension, including success rates and complications; and 3) a questionnaire about the preferred treatment and the reasons for the particular choice. Pelvic floor muscle training was the preferred management choice of 68/104 (65%) of participants; tension-free vaginal tape, 27 (26%); and open colposuspension six (6%) participants. The information sheets were the main basis for the particular choice in 86/104 (83%) of women. For the participants who chose pelvic floor muscle training 34/68 (50%) reported non-invasiveness and low risk as the main reasons for that particular choice. For participants who chose tension-free vaginal tape, the main reason was that it was a minimally invasive procedure.