Female Urology, Urodynamics, Incontinence, and Pelvic Floor Reconstructive SurgeryPelvic Organ Prolapse Surgery in Academic Female Pelvic Medicine and Reconstructive Surgery Urology Practice in the Setting of the Food and Drug Administration Public Health Notifications
Section snippets
Materials and Methods
Surgical volume for procedures performed by FPMRS specialists at eight academic institutions were collected using Current Procedural Terminology (CPT) codes for POP [45560, 57120, 57240, 57250, 57260, 57265, 57267, 57268, 57270, 57280, 57282, 57283, 57284, 57285, 57423, 57425] as well as mesh revision surgery [57295, 57296] but excluding procedures for SUI. The study was approved by the Medical University of South Carolina institutional review board and was inclusive of all participating
Results
This multi-institutional collaborative study included a total of 6680 interventions for POP performed during the time period January 1, 2007 to December 31, 2013. POP repair with mesh performed by practicing FPMRS at these academic centers has decreased substantially since 2007 (Fig. 1). The decreasing trend in POP mesh implant surgeries was found to be statistically significant (P ≤.0001). When the data were stratified by center, it was observed that there was a decreasing trend at each of the
Discussion
Current surgical trends in POP surgery have previously not been well defined in this era of increased scrutiny over procedures using transvaginal mesh. We found that there has been a dramatic shift in the use of TVM for POP surgery and a steady increase in the number of mesh revision surgeries performed at several tertiary care centers across the United States over the past 7 years. The observed trends are generally uniform among participating centers. Total surgical volume for POP has remained
Conclusion
This study and others before it are important for both a public health perspective and for practicing FPMRS as it pertains to changing practice patterns in POP surgery during this time of increased scrutiny regarding TVM. The use of TVM for POP among FPMRS in academic centers has drastically decreased over the last 7 years. In light of the current medico-legal and regulatory atmosphere, practice patterns and approaches for POP repair continue to evolve. The exact role for TVM for POP remains
Acknowledgment
The authors appreciate contributions by the biostatistics department at the Medical University of South Carolina.
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Financial Disclosure: The authors declare that they have no relevant financial interests.
Funding Support: The project and analysis described in the materials and methods section was supported by Award Number UL1TR000062 from the National Center for Advancing Translational Sciences. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.