The Use of Intraoperative Cystoscopy by General Gynaecologists in Canada

Abstract

BackgroundThe primary purpose of this study was to determine the intraoperative cystocopy practices of Canadian gynaecologists. The secondary aim was to identify barriers for the use of cystoscopy in this same population. MethodsAn 18-item questionnaire was sent to all active members of the Society of Obstetricians and Gynaecologists of Canada. The questionnaire included questions about basic demographic data and specific questions regarding cystoscopy use and barriers to use. ResultsThe response rate was 23% (236/1006). Two hundred thirty-one respondents practised gynaecology, and, of these, 48% (111/230) used intraoperative cystoscopy routinely (16/111, 14%), selectively (84/111, 75%), or for other reasons (12/111, 11%), primarily during tension-free vaginal tape procedures. The respondents used cystoscopy with the following procedures: colposuspension (61%), vaginal hysterectomy (23%), vaginal vault suspension (21%), and culdoplasty (20%). Cystoscopy was most commonly performed transurethrally (73%) with a 30 degree cystoscope. Lack of training was the most common reason cystoscopy was not used (70/118, 59%). Increased physician age (RR 0.47; CI 0.38–0.59, P < 0.01) and duration in practice of more than 10 years (RR 0.62; CI 0.46–0.83, P < 0.01) was associated with significantly decreased cystoscopy use. ConclusionIntraoperative cystoscopy is used by a significant number of Canadian gynaecologists for the detection of lower urinary tract injuries during gynaecologic surgery. Lack of training is the primary barrier to use of cystoscopy, and increasing physician age and duration of practice > 10 years are associated with decreased use of cystoscopy.