Saskatoon's Pelvic Floor Pathway; What are Surgical Referral Rates?

The Saskatchewan Pelvic Floor Pathway is a publicly funded provincial program providing education, assessment, and conservative treatment for women with pelvic floor disorders^[1]. The program established 2012 emphasizes an evidenced-based multidisciplinary, conservative approach for patients^[1-5]. We conducted a retrospective chart review of patients referred to the Pathway between 2018–2019. We tracked surgical procedures for this group of patients until August 2025. Our total cohort included 1790 patients, 110 of whom had surgery referrals from the Pathway to a surgical provider and 1680 who did not. Among 110 surgical referrals, 42% had surgery, the breakdown as follows: 57% prolapse repairs, 33% incontinence procedures, 9% surgery for both incontinence and prolapse, and 2% “other procedure(s)”. Among patients without surgical referral (1680), 122 patients (7.3%) eventually had surgery over the next 6 years: 35% incontinence, 33% prolapse procedures, 10% surgery for both incontinence and prolapse, 22% “other procedure(s)”. These results highlight differences in surgical rates and type of surgery between the groups and provide data into the effectiveness of this pathway model. This information could promote similar programs in other provinces across Canada to create a comprehensive plan to tackle Pelvic Floor disorders and hopefully decrease surgical rates.