"France's 10-year journey with mid-urethral slings: The rise of the TVT"

Today, mid urethral sling (MUS) is a controversial treatment in SUI. We presented a statement of MUS implantation in France since 2015.

It is an epidemiologic descriptive study. We extracted thanks to ATIH/Scan Santé data from procedure quotations (JDDB007 for retro-pubic MUS [RP-MUS] and JDDB005 for transobturator MUS [TO-MUS]) over the last ten years for public and private activities.

We observed a decrease in these procedures, especially for TO-MUS, with 25,225 and 7870 implantations in 2015 and 2024 respectively. This decrease is more pronounced in the private sector. For RP-MUS procedures, there is a stability of acts with 6328 and 6758 RP-MUS in respectively 2015 and 2024. In 2024, TO/RP MUS ratio is about 1.16. In 2015, the private part of RP-MUS and TO-MUS activities were 54.6% and 59.5% respectively. In 2024, the private activity of RP-MUS and TO-MUS surgery were 57.4% and 68.9% respectively.

Many reasons should explain this statement: COVID crisis, French stronger recommendations, pressure of media and public opinion, poor valuation of these procedures in the private sector… It's time to encourage good training and practice to save this surgery, which is still a good revolution and the gold standard for female stress incontinence.