Prolapse repair with and without apical resuspension—Practice patterns among certifying American urologists

Joceline S. Liu, Oluwarotimi Nettey, Amanda X. Vo, Matthias Dominikus Hofer, Sarah C Flury, Stephanie J Kielb*

*Corresponding author for this work

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Aims: To examine surgeon characteristics in certifying urologists performing prolapse surgeries. Anterior compartment prolapse is often associated with apical prolapse, with high rates of recurrence when anterior repair is performed without apical resuspension. Methods: Six-month case log data of certifying urologists between 2003 and 2013 was obtained from the American Board of Urology (ABU). Cases with a CPT code for common prolapse repairs in females ≥18 years were analyzed. Results: Among 2,588 urologists logging at least one prolapse surgery and a total of 30,983 surgeries, 320 (1.0% of all cases) uterosacral ligament suspension, 3,673 (11.9%) sacrospinous ligament suspension, and 2,618 (8.4%) abdominal sacrocolpopexy were identified. The remaining 14,585 cases were logged as anterior repair. 54.7% of anterior repairs did not include apical suspension. The proportion of anterior repairs without apical suspension has decreased from 77.7% in 2004 to 41.4% in 2012 (P < 0.001). Female subspecialists before 2011 performed anterior repair without apical suspension in 58.5%, versus 70.3% by all others. Since 2011 there has been a decrease in number of anterior repairs without apical suspension, notably in those applying for Female Pelvic Medicine and Reconstructive Surgery (FPMRS) certification (17.1% vs. 30.7% by all other urologists, P < 0.001); nonacademically affiliated urologists are 2.1 times more likely to report anterior repair without apical suspension than academically affiliated colleagues (P < 0.001). Conclusions: The proportion of prolapse repairs reported as anterior repairs without apical suspension is decreasing, although it remains a substantial portion. Recent log year, FPMRS, and academic affiliation were associated with prolapse repairs addressing apical support. Neurourol. Urodynam. 36:344–348, 2017.

Original languageEnglish (US)
Pages (from-to)344-348
Number of pages5
JournalNeurourology and Urodynamics
Volume36
Issue number2
DOIs
StatePublished - Feb 1 2017

Fingerprint

Prolapse
Suspensions
Reconstructive Surgical Procedures
Ligaments
Current Procedural Terminology
Medicine
Urologists
Certification
Urology
Recurrence

Keywords

  • American Board of Urology
  • cystocele
  • pelvic organ prolapse
  • practice patterns

ASJC Scopus subject areas

  • Clinical Neurology
  • Urology

Cite this

@article{a12924922e5d43f683e292342ab615ca,
title = "Prolapse repair with and without apical resuspension—Practice patterns among certifying American urologists",
abstract = "Aims: To examine surgeon characteristics in certifying urologists performing prolapse surgeries. Anterior compartment prolapse is often associated with apical prolapse, with high rates of recurrence when anterior repair is performed without apical resuspension. Methods: Six-month case log data of certifying urologists between 2003 and 2013 was obtained from the American Board of Urology (ABU). Cases with a CPT code for common prolapse repairs in females ≥18 years were analyzed. Results: Among 2,588 urologists logging at least one prolapse surgery and a total of 30,983 surgeries, 320 (1.0{\%} of all cases) uterosacral ligament suspension, 3,673 (11.9{\%}) sacrospinous ligament suspension, and 2,618 (8.4{\%}) abdominal sacrocolpopexy were identified. The remaining 14,585 cases were logged as anterior repair. 54.7{\%} of anterior repairs did not include apical suspension. The proportion of anterior repairs without apical suspension has decreased from 77.7{\%} in 2004 to 41.4{\%} in 2012 (P < 0.001). Female subspecialists before 2011 performed anterior repair without apical suspension in 58.5{\%}, versus 70.3{\%} by all others. Since 2011 there has been a decrease in number of anterior repairs without apical suspension, notably in those applying for Female Pelvic Medicine and Reconstructive Surgery (FPMRS) certification (17.1{\%} vs. 30.7{\%} by all other urologists, P < 0.001); nonacademically affiliated urologists are 2.1 times more likely to report anterior repair without apical suspension than academically affiliated colleagues (P < 0.001). Conclusions: The proportion of prolapse repairs reported as anterior repairs without apical suspension is decreasing, although it remains a substantial portion. Recent log year, FPMRS, and academic affiliation were associated with prolapse repairs addressing apical support. Neurourol. Urodynam. 36:344–348, 2017.",
keywords = "American Board of Urology, cystocele, pelvic organ prolapse, practice patterns",
author = "Liu, {Joceline S.} and Oluwarotimi Nettey and Vo, {Amanda X.} and Hofer, {Matthias Dominikus} and Flury, {Sarah C} and Kielb, {Stephanie J}",
year = "2017",
month = "2",
day = "1",
doi = "10.1002/nau.22926",
language = "English (US)",
volume = "36",
pages = "344--348",
journal = "Neurourology and Urodynamics",
issn = "0733-2467",
publisher = "Wiley-Liss Inc.",
number = "2",

}

Prolapse repair with and without apical resuspension—Practice patterns among certifying American urologists. / Liu, Joceline S.; Nettey, Oluwarotimi; Vo, Amanda X.; Hofer, Matthias Dominikus; Flury, Sarah C; Kielb, Stephanie J.

In: Neurourology and Urodynamics, Vol. 36, No. 2, 01.02.2017, p. 344-348.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Prolapse repair with and without apical resuspension—Practice patterns among certifying American urologists

AU - Liu, Joceline S.

AU - Nettey, Oluwarotimi

AU - Vo, Amanda X.

AU - Hofer, Matthias Dominikus

AU - Flury, Sarah C

AU - Kielb, Stephanie J

PY - 2017/2/1

Y1 - 2017/2/1

N2 - Aims: To examine surgeon characteristics in certifying urologists performing prolapse surgeries. Anterior compartment prolapse is often associated with apical prolapse, with high rates of recurrence when anterior repair is performed without apical resuspension. Methods: Six-month case log data of certifying urologists between 2003 and 2013 was obtained from the American Board of Urology (ABU). Cases with a CPT code for common prolapse repairs in females ≥18 years were analyzed. Results: Among 2,588 urologists logging at least one prolapse surgery and a total of 30,983 surgeries, 320 (1.0% of all cases) uterosacral ligament suspension, 3,673 (11.9%) sacrospinous ligament suspension, and 2,618 (8.4%) abdominal sacrocolpopexy were identified. The remaining 14,585 cases were logged as anterior repair. 54.7% of anterior repairs did not include apical suspension. The proportion of anterior repairs without apical suspension has decreased from 77.7% in 2004 to 41.4% in 2012 (P < 0.001). Female subspecialists before 2011 performed anterior repair without apical suspension in 58.5%, versus 70.3% by all others. Since 2011 there has been a decrease in number of anterior repairs without apical suspension, notably in those applying for Female Pelvic Medicine and Reconstructive Surgery (FPMRS) certification (17.1% vs. 30.7% by all other urologists, P < 0.001); nonacademically affiliated urologists are 2.1 times more likely to report anterior repair without apical suspension than academically affiliated colleagues (P < 0.001). Conclusions: The proportion of prolapse repairs reported as anterior repairs without apical suspension is decreasing, although it remains a substantial portion. Recent log year, FPMRS, and academic affiliation were associated with prolapse repairs addressing apical support. Neurourol. Urodynam. 36:344–348, 2017.

AB - Aims: To examine surgeon characteristics in certifying urologists performing prolapse surgeries. Anterior compartment prolapse is often associated with apical prolapse, with high rates of recurrence when anterior repair is performed without apical resuspension. Methods: Six-month case log data of certifying urologists between 2003 and 2013 was obtained from the American Board of Urology (ABU). Cases with a CPT code for common prolapse repairs in females ≥18 years were analyzed. Results: Among 2,588 urologists logging at least one prolapse surgery and a total of 30,983 surgeries, 320 (1.0% of all cases) uterosacral ligament suspension, 3,673 (11.9%) sacrospinous ligament suspension, and 2,618 (8.4%) abdominal sacrocolpopexy were identified. The remaining 14,585 cases were logged as anterior repair. 54.7% of anterior repairs did not include apical suspension. The proportion of anterior repairs without apical suspension has decreased from 77.7% in 2004 to 41.4% in 2012 (P < 0.001). Female subspecialists before 2011 performed anterior repair without apical suspension in 58.5%, versus 70.3% by all others. Since 2011 there has been a decrease in number of anterior repairs without apical suspension, notably in those applying for Female Pelvic Medicine and Reconstructive Surgery (FPMRS) certification (17.1% vs. 30.7% by all other urologists, P < 0.001); nonacademically affiliated urologists are 2.1 times more likely to report anterior repair without apical suspension than academically affiliated colleagues (P < 0.001). Conclusions: The proportion of prolapse repairs reported as anterior repairs without apical suspension is decreasing, although it remains a substantial portion. Recent log year, FPMRS, and academic affiliation were associated with prolapse repairs addressing apical support. Neurourol. Urodynam. 36:344–348, 2017.

KW - American Board of Urology

KW - cystocele

KW - pelvic organ prolapse

KW - practice patterns

UR - http://www.scopus.com/inward/record.url?scp=84948845850&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84948845850&partnerID=8YFLogxK

U2 - 10.1002/nau.22926

DO - 10.1002/nau.22926

M3 - Article

VL - 36

SP - 344

EP - 348

JO - Neurourology and Urodynamics

JF - Neurourology and Urodynamics

SN - 0733-2467

IS - 2

ER -