TY - JOUR
T1 - Performance of Perioperative Tasks for Women Undergoing Anti-incontinence Surgery
AU - Erekson, Elisabeth
AU - Whitcomb, Emily L.
AU - Kamdar, Neil
AU - Swift, Steve
AU - Cundiff, Geoffrey W.
AU - Yaklic, Jerome
AU - Strohbehn, Kris
AU - Adam, Rony
AU - Danford, Jill
AU - Willis-Gray, Marcella G.
AU - Maxwell, Rose
AU - Edenfield, Autumn
AU - Pulliam, Samantha
AU - Gong, Merry
AU - Malek, MacKenzie
AU - Hanissian, Paul
AU - Towers, Geoffrey
AU - Guaderrama, Noelani M.
AU - Slocum, Paul
AU - Morgan, Daniel
N1 - Publisher Copyright:
© 2023 The Author(s).
PY - 2023/8/1
Y1 - 2023/8/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85165661264&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85165661264&partnerID=8YFLogxK
U2 - 10.1097/SPV.0000000000001392
DO - 10.1097/SPV.0000000000001392
M3 - Article
C2 - 37490706
AN - SCOPUS:85165661264
SN - 2151-8378
VL - 29
SP - 660
EP - 669
JO - Urogynecology
JF - Urogynecology
IS - 8
ER -