Do Local Multidisciplinary Team Meetings in the UK Alter Management Recommendations for Invasive Treatment of Stress Urinary Incontinence?

Abstract

<h4>Introduction and hypothesis</h4>Traditional single-specialty approaches may be insufficient for managing surgical interventions in women with stress urinary incontinence (SUI). Limited data exist on the effectiveness of multidisciplinary teams (MDTs) in the decision-making process since NICE introduced the concept in 2013. This study evaluates the impact of a purpose-designed MDT on SUI management from 2017 to 2019.<h4>Methods</h4>Monthly MDT meetings at a university hospital and a district general hospital reviewed cases of women considering invasive treatment for primary SUI. Attendees included gynaecologists, urologists, continence nurses, physiotherapists, and administrative staff. Discussions focussed on patient history, urodynamics, treatment preferences, and final recommendations. Data on age, parity, BMI, diagnoses, and treatment plans were analysed using SPSS Statistics (version 23).<h4>Results</h4>A total of 123 women were discussed (mean age 54.5 years, mean BMI 30.8). Of 96 cases with MDT decisions, colposuspension was most recommended (46.9%), followed by bulking agent injection (37.5%) and autologous fascial sling (8.3%). MDTs altered management in 19/123 cases (15.4%), primarily shifting towards less invasive interventions. No mesh tape procedures were recommended despite availability. Among 86 women who identified priorities, cure from leakage (96.5%) and avoiding repeat surgery (47.7%) ranked highest.<h4>Conclusion</h4>MDT discussions influenced treatment decisions by favouring conservative management options in many women. Patient preferences were fully considered during MDT discussions. Further studies should be conducted to assess long-term clinical outcomes following MDT recommendations.