Survey perineorrhaphy/perineoplasty IUGA

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* 1. Are you a (uro)gynaecologist or urologist?

(Uro)gynaecologist

Urologist

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* 2. How many years have you been a specialist?

1-5 years

5-10 years

>10 years

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* 3. Did you follow an additional urogynaecological training

I followed a formal subspecialty training

In my country there is no formal fellowship/at the time I was trained there was no formal fellowship, but I underwent additional training

I followed no additional training

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* 4. How many new patients with prolapse do you see per year?

<400 per year

400-800 per year

>800 per year

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* 5. How many POP surgeries do you perform per year (procedures for SUI not included)?

<100 POP surgeries per year

100-250 POP surgeries per year

>250 POP surgeries per year

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* 6. How does your surgical practice approximately look like?

0-25% vaginal procedures and 75-100% laparoscopic/robotic procedures

around 50% vaginal procedures and around 50% laparoscopic/robotic procedures

75-100% vaginal procedures and 0-25% laparoscopic/robotic procedures

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* 7. Do you ever perform a perineorrhaphy/perineoplasty?
If no please continue to question 17

Yes

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* 8. When performing a perineorrhapy/perineoplasty, do you normally excise epithelial tissue?

Yes I excise epithelial tissue when performing a perineorrhapy/perineoplasty

No I do not excise epithelial tissue when performing a perineorrhaphy/perineoplasty

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* 9. If yes, how much do you excise?

I try to be as restrictive as possible

I individualize the amount

I take out as much as possible

I do not excide tissue when performing a perineorrhaphy/perineoplasty

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* 10. Do you intend to narrow the vagina?

Always

Often

Depends on the case

Seldom

Never

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* 11. Do you intend to prevent narrowing of the vagina?

Always

Often

Depends on the case

Seldom

Never

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* 12. Do you approximate the bulbocavernosus muscle?

Yes

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* 13. If yes, with how many sutures?

mostly 1 or 2 sutures

mostly 2 to 4 sutures

mostly 4 sutures or more

depends on the size of the perineorrhaphy/perineoplasty

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* 14. Do you extend surgery to the puborectal (levator) muscle?

Yes

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* 15. What kind of sutures do you use for approximating the muscle?

usually 2/0

usually 0

other

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* 16. If you perform a perineorrhaphy/perineoplasty, is it performed at the time of (vaginal) prolapse surgery?

Always as a combination

Often as a combination

Depends on the case

Seldom as a combination

Never, always separate

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* 17. What are, in your opinion, indications for performing a perineorrhaphy/perineoplasty?

	Absolutely not a good indication	Mostly not a good indication	Neutral	A bit/sometimes a good indication	Excellent indication
Wide genital hiatus at physical examination by POP-Q	Wide genital hiatus at physical examination by POP-Q Absolutely not a good indication	Wide genital hiatus at physical examination by POP-Q Mostly not a good indication	Wide genital hiatus at physical examination by POP-Q Neutral	Wide genital hiatus at physical examination by POP-Q A bit/sometimes a good indication	Wide genital hiatus at physical examination by POP-Q Excellent indication
Subjective complaints of the patient of a wide genital hiatus (the feeling of "being open")	Subjective complaints of the patient of a wide genital hiatus (the feeling of "being open") Absolutely not a good indication	Subjective complaints of the patient of a wide genital hiatus (the feeling of "being open") Mostly not a good indication	Subjective complaints of the patient of a wide genital hiatus (the feeling of "being open") Neutral	Subjective complaints of the patient of a wide genital hiatus (the feeling of "being open") A bit/sometimes a good indication	Subjective complaints of the patient of a wide genital hiatus (the feeling of "being open") Excellent indication
Subjective complaints of the patient of vaginal flatus	Subjective complaints of the patient of vaginal flatus Absolutely not a good indication	Subjective complaints of the patient of vaginal flatus Mostly not a good indication	Subjective complaints of the patient of vaginal flatus Neutral	Subjective complaints of the patient of vaginal flatus A bit/sometimes a good indication	Subjective complaints of the patient of vaginal flatus Excellent indication
Subjective complaints of the patient of insufficient friction during intercourse	Subjective complaints of the patient of insufficient friction during intercourse Absolutely not a good indication	Subjective complaints of the patient of insufficient friction during intercourse Mostly not a good indication	Subjective complaints of the patient of insufficient friction during intercourse Neutral	Subjective complaints of the patient of insufficient friction during intercourse A bit/sometimes a good indication	Subjective complaints of the patient of insufficient friction during intercourse Excellent indication
Subjective complaints of patients partner of insufficient friction during intercourse	Subjective complaints of patients partner of insufficient friction during intercourse Absolutely not a good indication	Subjective complaints of patients partner of insufficient friction during intercourse Mostly not a good indication	Subjective complaints of patients partner of insufficient friction during intercourse Neutral	Subjective complaints of patients partner of insufficient friction during intercourse A bit/sometimes a good indication	Subjective complaints of patients partner of insufficient friction during intercourse Excellent indication
Fecal incontinence	Fecal incontinence Absolutely not a good indication	Fecal incontinence Mostly not a good indication	Fecal incontinence Neutral	Fecal incontinence A bit/sometimes a good indication	Fecal incontinence Excellent indication
Treatment of milde (stage 1) apical prolapse	Treatment of milde (stage 1) apical prolapse Absolutely not a good indication	Treatment of milde (stage 1) apical prolapse Mostly not a good indication	Treatment of milde (stage 1) apical prolapse Neutral	Treatment of milde (stage 1) apical prolapse A bit/sometimes a good indication	Treatment of milde (stage 1) apical prolapse Excellent indication
Perineal pain	Perineal pain Absolutely not a good indication	Perineal pain Mostly not a good indication	Perineal pain Neutral	Perineal pain A bit/sometimes a good indication	Perineal pain Excellent indication
Perineal skin problems	Perineal skin problems Absolutely not a good indication	Perineal skin problems Mostly not a good indication	Perineal skin problems Neutral	Perineal skin problems A bit/sometimes a good indication	Perineal skin problems Excellent indication

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* 18. What are, in your opinion, reasons to not perform a perineorrhaphy/perineoplasty?

	Absolutely not a reason to withdrawal from perineorrhaphy/perineoplasty	Mostly not a reason to withdrawal from perineorrhaphy/perineoplasty	Neutral	Sometimes a good reason to withdrawal from perineorrhaphy/perineoplasty	Excellent reason to withdrawal from perineorrhaphy/perineoplasty
Current pelvic pain	Current pelvic pain Absolutely not a reason to withdrawal from perineorrhaphy/perineoplasty	Current pelvic pain Mostly not a reason to withdrawal from perineorrhaphy/perineoplasty	Current pelvic pain Neutral	Current pelvic pain Sometimes a good reason to withdrawal from perineorrhaphy/perineoplasty	Current pelvic pain Excellent reason to withdrawal from perineorrhaphy/perineoplasty
Current dyspareunia	Current dyspareunia Absolutely not a reason to withdrawal from perineorrhaphy/perineoplasty	Current dyspareunia Mostly not a reason to withdrawal from perineorrhaphy/perineoplasty	Current dyspareunia Neutral	Current dyspareunia Sometimes a good reason to withdrawal from perineorrhaphy/perineoplasty	Current dyspareunia Excellent reason to withdrawal from perineorrhaphy/perineoplasty
Fear of developing pelvic pain	Fear of developing pelvic pain Absolutely not a reason to withdrawal from perineorrhaphy/perineoplasty	Fear of developing pelvic pain Mostly not a reason to withdrawal from perineorrhaphy/perineoplasty	Fear of developing pelvic pain Neutral	Fear of developing pelvic pain Sometimes a good reason to withdrawal from perineorrhaphy/perineoplasty	Fear of developing pelvic pain Excellent reason to withdrawal from perineorrhaphy/perineoplasty
Fear of developing dyspareunia	Fear of developing dyspareunia Absolutely not a reason to withdrawal from perineorrhaphy/perineoplasty	Fear of developing dyspareunia Mostly not a reason to withdrawal from perineorrhaphy/perineoplasty	Fear of developing dyspareunia Neutral	Fear of developing dyspareunia Sometimes a good reason to withdrawal from perineorrhaphy/perineoplasty	Fear of developing dyspareunia Excellent reason to withdrawal from perineorrhaphy/perineoplasty
Prolonged time of surgery	Prolonged time of surgery Absolutely not a reason to withdrawal from perineorrhaphy/perineoplasty	Prolonged time of surgery Mostly not a reason to withdrawal from perineorrhaphy/perineoplasty	Prolonged time of surgery Neutral	Prolonged time of surgery Sometimes a good reason to withdrawal from perineorrhaphy/perineoplasty	Prolonged time of surgery Excellent reason to withdrawal from perineorrhaphy/perineoplasty

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* 19. At what genital hiatus size would you consider to perform a perineorrhaphy/perineoplasty?

Genital hiatus at POP-Q of 2-4 cm

Genital hiatus at POP-Q of 4 or more cm

Genital hiatus at POP-Q of 6 or more cm

Genital hiatus at POP-Q of 8 or more cm

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* 20. Is there scientific evidence to perform a perineorrhaphy/perineoplasty on indication?

Yes, there is scientific evidence to be liberal with perineorrhaphy/perineoplasty

Yes, there is scientific evidence to indicate some patients for perineorrhaphy/perineoplasty

Yes, there is scientific evidence to not indicate patients for perineorrhaphy/perineoplasty

There is no scientific evidence to decide when perineorrhaphy/perineoplasty is indicated

I do not know if there is any scientific evidence about perineorrhaphy/perineoplasty

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* 21. Is there clinical evidence to perform a perineorrhaphy/perineoplasty on indication based on your experience?

Yes, in my opinion there is clinical evidence to be liberal with perineorrhaphy/perineoplasty

Yes, in my opinion there is clinical evidence to indicate some patients for perineorrhaphy/perineoplasty

Yes, in my opinion there is clinical evidence to not indicate for perineorrhaphy/perineoplasty

No, in my opinion there is no clinical evidence to decide when perineorrhaphy/perineoplasty is indicated

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* 22. How relevant is it to perform further research on the (possible) added value of perineorrhaphy/perineoplasty on a scale of 1-10?
1: absolutely not relevant/important, 10: extremely relevant/important

Wissen

i We adjusted the number you entered based on the slider’s scale.

Survey perineorrhaphy/perineoplasty IUGA

Question Title

* 1. Are you a (uro)gynaecologist or urologist?

Question Title

* 2. How many years have you been a specialist?

Question Title

* 3. Did you follow an additional urogynaecological training

Question Title

* 4. How many new patients with prolapse do you see per year?

Question Title

* 5. How many POP surgeries do you perform per year (procedures for SUI not included)?

Question Title

* 6. How does your surgical practice approximately look like?

Question Title

* 7. Do you ever perform a perineorrhaphy/perineoplasty?If no please continue to question 17

Question Title

* 8. When performing a perineorrhapy/perineoplasty, do you normally excise epithelial tissue?

Question Title

* 9. If yes, how much do you excise?

Question Title

* 10. Do you intend to narrow the vagina?

Question Title

* 11. Do you intend to prevent narrowing of the vagina?

Question Title

* 12. Do you approximate the bulbocavernosus muscle?

Question Title

* 13. If yes, with how many sutures?

Question Title

* 14. Do you extend surgery to the puborectal (levator) muscle?

Question Title

* 15. What kind of sutures do you use for approximating the muscle?

Question Title

* 16. If you perform a perineorrhaphy/perineoplasty, is it performed at the time of (vaginal) prolapse surgery?

Question Title

* 17. What are, in your opinion, indications for performing a perineorrhaphy/perineoplasty?

Question Title

* 18. What are, in your opinion, reasons to not perform a perineorrhaphy/perineoplasty?

Question Title

* 19. At what genital hiatus size would you consider to perform a perineorrhaphy/perineoplasty?

Question Title

* 20. Is there scientific evidence to perform a perineorrhaphy/perineoplasty on indication?

Question Title

* 21. Is there clinical evidence to perform a perineorrhaphy/perineoplasty on indication based on your experience?

Question Title

* 22. How relevant is it to perform further research on the (possible) added value of perineorrhaphy/perineoplasty on a scale of 1-10?1: absolutely not relevant/important, 10: extremely relevant/important

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* 23. Is there anything else you would like to say about this topic?

* 7. Do you ever perform a perineorrhaphy/perineoplasty?
If no please continue to question 17

* 22. How relevant is it to perform further research on the (possible) added value of perineorrhaphy/perineoplasty on a scale of 1-10?
1: absolutely not relevant/important, 10: extremely relevant/important