Abstract：
BACKGROUND: Since the banning of trans-vaginal meshes for pelvic organ prolapse treatment by the FDA in 2019, French authorities have been gradually regulating the use of prosthetic materials in urogynecology. The decision to fit a mid-urethral sling or a reinforcement implant for the cure of prolapse, as well as the management of complex genital prolapse and serious post-implant complications, must be the subject of multidisciplinary consultation and a shared medical decision. To comply with these regulations, multidisciplinary team meetings (MDTMs) have been set up. The aim of the study was to evaluate the impact of these meetings on patient management.
METHODS: We carried out a retrospective study in a tertiary hospital in France on all cases presented in MDTM of urogynecology over the year 2022. MDTMs were held weekly, with a \"Prosthesis MDTM\" focusing on slings, sacrocolpo/hysteropexies and prosthetic complications, lead by the urology team, and a \"Prolapse MDTM\" focusing on pelvic organ prolapse and complex prolapses, lead by the gynecology team. We compared the initial proposal of the patient\'s referring physician versus the final proposal of the MDTM.
RESULTS: Three hundred and seventy-five cases were presented in our center in 2022: 188 in Prosthetic MDTM and 187 in Prolapse MDTM. The Prosthetic and Static MDTMs agreed with the initial proposal in 83 and 64% of cases respectively, while the therapeutic strategy was questioned in 12 and 36% of cases respectively.
CONCLUSIONS: For almost a quarter (24%) of patients, the MDTM of urogynecology opted for a different management from that proposed by the referring physician. The presentation of cases to the MDTM is a legal obligation in specific indications. It also plays an educational role, enabling shared decision-making and responsibility, which is an asset in functional surgery.
METHODS:
METHODS: We carried out a retrospective study in a tertiary hospital in France on all cases presented in MDTM of urogynecology over the year 2022. MDTMs were held weekly, with a \"Prosthesis MDTM\" focusing on slings, sacrocolpo/hysteropexies and prosthetic complications, lead by the urology team, and a \"Prolapse MDTM\" focusing on pelvic organ prolapse and complex prolapses, lead by the gynecology team. We compared the initial proposal of the patient\'s referring physician versus the final proposal of the MDTM.
RESULTS: Three hundred and seventy-five cases were presented in our center in 2022: 188 in Prosthetic MDTM and 187 in Prolapse MDTM. The Prosthetic and Static MDTMs agreed with the initial proposal in 83 and 64% of cases respectively, while the therapeutic strategy was questioned in 12 and 36% of cases respectively.
CONCLUSIONS: For almost a quarter (24%) of patients, the MDTM of urogynecology opted for a different management from that proposed by the referring physician. The presentation of cases to the MDTM is a legal obligation in specific indications. It also plays an educational role, enabling shared decision-making and responsibility, which is an asset in functional surgery.
METHODS:
摘要：
背景：自2019年FDA禁止用于盆腔器官脱垂治疗的经阴道网状物以来，法国当局一直在逐步规范在泌尿妇科中使用假体材料。决定安装尿道中段吊带或加固植入物以治疗脱垂，以及复杂的生殖器脱垂和严重的植入后并发症的管理，必须是多学科咨询和共同医疗决策的主题。为了遵守这些规定，已经建立了多学科小组会议（MDTM）。该研究的目的是评估这些会议对患者管理的影响。
方法：我们在法国的一家三级医院进行了一项回顾性研究，研究对象是2022年所有妇科MDTM病例。MDTM每周举行，带有“假体MDTM”，专注于吊索，sacrocolpo/子宫内固定和假体并发症，由泌尿外科团队领导,和“脱垂MDTM”专注于盆腔器官脱垂和复杂脱垂，由妇科团队领导。我们比较了患者转诊医师的最初建议与MDTM的最终建议。
结果：2022年，我们中心提出了三百七十五例：修复MDTM中的188例和脱垂MDTM中的187例。修复和静态MDTM分别在83％和64％的情况下同意最初的建议，而治疗策略分别在12％和36％的病例中受到质疑。
结论：对于近四分之一(24%)的患者，泌尿系妇科的MDTM选择了与转诊医师提出的不同的管理。向MDTM提交案件是特定适应症的法律义务。它也起着教育作用，实现共同决策和责任，这是功能性手术的资产。
方法：
方法：我们在法国的一家三级医院进行了一项回顾性研究，研究对象是2022年所有妇科MDTM病例。MDTM每周举行，带有“假体MDTM”，专注于吊索，sacrocolpo/子宫内固定和假体并发症，由泌尿外科团队领导,和“脱垂MDTM”专注于盆腔器官脱垂和复杂脱垂，由妇科团队领导。我们比较了患者转诊医师的最初建议与MDTM的最终建议。
结果：2022年，我们中心提出了三百七十五例：修复MDTM中的188例和脱垂MDTM中的187例。修复和静态MDTM分别在83％和64％的情况下同意最初的建议，而治疗策略分别在12％和36％的病例中受到质疑。
结论：对于近四分之一(24%)的患者，泌尿系妇科的MDTM选择了与转诊医师提出的不同的管理。向MDTM提交案件是特定适应症的法律义务。它也起着教育作用，实现共同决策和责任，这是功能性手术的资产。
方法：
