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21st century management trend of female stress incontinence in Australia

O. Perera¹, Y. Ho¹, M. Arianayagam¹, B. Canagasingham¹, N. Jeffery¹, M. Khadra¹, R. Ko¹, N. Mehan¹, C. Varol¹, I. Thangasamy¹

¹Nepean Urology Research Group, Urology, Kingswood, Australia

Introduction:

This study aims to review the current trend of female stress urinary incontinence management in the past two decades in Australia.

Material and methods:

Using the Australian Institute of Health & Welfare and Medicare Benefits Scheme (MBS) database we have collected data related to female stress urinary incontinence (SUI) procedures performed between financial year (FY) 2000/01 to 2022/23. The MBS procedures for female SUI include paraurethral injection, retropubic and slings. The data consist of procedure counts, differentiated by gender, age, and revisions. The national and state financial burden for incontinence was calculated from MBS data.

Results:

Between FY2000/01 to 2022/23 we have identified a 57.5% reduction in female SUI procedures performed. Despite this decrease, we found a 58% increase in paraurethral injections over this same period. We found a 68.2% increase in revision procedures performed and division of sling was the most commonly performed revision procedure. The national aggregate cost of female SUI procedures has reduced since FY2002/03, by 50.6% and NSW contributed the most to this national aggregate cost. Within this cost, we saw reduction in retropubic procedures by 83.1% and sling procedure by 46.9%, while cost of paraurethral injection increased by 261.2% and division of slings by 192.9%.