Performance of Perioperative Tasks for Women Undergoing Anti-incontinence Surgery

Elisabeth Erekson, Emily L. Whitcomb, Neil Kamdar, Steve Swift, Geoffrey W. Cundiff, Jerome Yaklic, Kris Strohbehn, Rony Adam, Jill Danford, Marcella G. Willis-Gray, Rose Maxwell, Autumn Edenfield, Samantha Pulliam, Merry Gong, MacKenzie Malek, Paul Hanissian, Geoffrey Towers, Noelani M. Guaderrama, Paul Slocum, Daniel Morgan

Research output: Contribution to journalArticlepeer-review


Surgery for the correction of stress urinary incontinence is an elective procedure that can have a dramatic and positive impact on quality of life. Anti-incontinence procedures, like inguinal hernia repairs or cholecystectomies, can be classified as high-volume/low-morbidity procedures. The performance of a standard set of perioperative tasks has been suggested as one way to optimize quality of care in elective high-volume/low-morbidity procedures. Our primary objective was to evaluate the performance of 5 perioperative tasks - (1) offering nonsurgical treatment, (2) performance of a standard preoperative prolapse examination, (3) cough stress test, (4) postvoid residual test, and (5) intraoperative cystoscopy for women undergoing surgery for stress urinary incontinence - compared among surgeons with and without board certification in female pelvic medicine and reconstructive surgery (FPMRS). Study Design: This study was a retrospective chart review of anti-incontinence surgical procedures performed between 2011 and 2013 at 9 health systems. Cases were reviewed for surgical volume, adverse outcomes, and the performance of 5 perioperative tasks and compared between surgeons with and without FPMRS certification. Results: Non-FPMRS surgeons performed fewer anti-incontinence procedures than FPMRS-certified surgeons. Female pelvic medicine and reconstructive surgery surgeons were more likely to perform all 5 perioperative tasks compared with non-FPMRS surgeons. After propensity matching, FPMRS surgeons had fewer patients readmitted within 30 days of surgery compared with non-FPMRS surgeons. Conclusions: Female pelvic medicine and reconstructive surgery surgeons performed higher volumes of anti-incontinence procedures, were more likely to document the performance of the 5 perioperative tasks, and were less likely to have their patients readmitted within 30 days.

Original languageEnglish (US)
Pages (from-to)660-669
Number of pages10
Issue number8
StatePublished - Aug 1 2023

ASJC Scopus subject areas

  • Surgery
  • Obstetrics and Gynecology
  • Urology


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