Changes in Pelvic Organ Prolapse Surgery Over the Last Decade Among U.S. Urologists
CUA Online Library. Elterman D. 06/22/13; 31436; UP-57
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Abstract
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ABSTRACT
Introduction and Objective:
Surgical correction of POP has undergone a transformation over the past decade. Training in POP surgery, ease of mesh kit use and FDA warnings on mesh have influenced practice patterns. We investigated trends in POP procedures.
Materials and Methods:
Data on POP procedures, mesh usage, pessary placement performed between 2003 and 2012 by certifying and recertifying urologists were obtained in the form of annualized case logs from the American Board of Urology (ABU). Associations between surgeon characteristics (type of certification, annual volume, practice type and location) and use of POP procedures were evaluated.
Results:
2192 out of 6,355 non-pediatric urologists applying for certification or recertification reported performing POP procedures during the study period - numbers of which increased steadily from 930 in 2003 to 6,978 in 2012. Colporrhaphies increased from 806 to 2670. Colpopexies increased steadily from 32 to 1414 during the study period. Vaginal colpopexies increased from 24 to 1016. Sacrocolpopexies rose from 8 to 398 with laparoscopic sacrocolpopexy showing exponential increases (282 cases by 2012). Mesh insertion rose from 10 in 2005 to 1552 in 2012 (p < 0.0005). Mesh revisions, first reported in 2007 with 52 performed, increased consistently to 214 in 2012. Urologists trained in female urology performed more POP procedures (17 more per year), as did female urologists (18 more per year), and those recertifying (6 more per year than initial certification).
Conclusions:
Urologist performed POP surgery has increased dramatically over the last decade with a similar rise in mesh usage. More colpopexies are now performed with laparoscopic sacrocolpopexy showing exponential increase. The recent trend of mesh revisions, which show much faster rate of increase than mesh insertions, is noteworthy.
Introduction and Objective:
Surgical correction of POP has undergone a transformation over the past decade. Training in POP surgery, ease of mesh kit use and FDA warnings on mesh have influenced practice patterns. We investigated trends in POP procedures.
Materials and Methods:
Data on POP procedures, mesh usage, pessary placement performed between 2003 and 2012 by certifying and recertifying urologists were obtained in the form of annualized case logs from the American Board of Urology (ABU). Associations between surgeon characteristics (type of certification, annual volume, practice type and location) and use of POP procedures were evaluated.
Results:
2192 out of 6,355 non-pediatric urologists applying for certification or recertification reported performing POP procedures during the study period - numbers of which increased steadily from 930 in 2003 to 6,978 in 2012. Colporrhaphies increased from 806 to 2670. Colpopexies increased steadily from 32 to 1414 during the study period. Vaginal colpopexies increased from 24 to 1016. Sacrocolpopexies rose from 8 to 398 with laparoscopic sacrocolpopexy showing exponential increases (282 cases by 2012). Mesh insertion rose from 10 in 2005 to 1552 in 2012 (p < 0.0005). Mesh revisions, first reported in 2007 with 52 performed, increased consistently to 214 in 2012. Urologists trained in female urology performed more POP procedures (17 more per year), as did female urologists (18 more per year), and those recertifying (6 more per year than initial certification).
Conclusions:
Urologist performed POP surgery has increased dramatically over the last decade with a similar rise in mesh usage. More colpopexies are now performed with laparoscopic sacrocolpopexy showing exponential increase. The recent trend of mesh revisions, which show much faster rate of increase than mesh insertions, is noteworthy.
ABSTRACT
Introduction and Objective:
Surgical correction of POP has undergone a transformation over the past decade. Training in POP surgery, ease of mesh kit use and FDA warnings on mesh have influenced practice patterns. We investigated trends in POP procedures.
Materials and Methods:
Data on POP procedures, mesh usage, pessary placement performed between 2003 and 2012 by certifying and recertifying urologists were obtained in the form of annualized case logs from the American Board of Urology (ABU). Associations between surgeon characteristics (type of certification, annual volume, practice type and location) and use of POP procedures were evaluated.
Results:
2192 out of 6,355 non-pediatric urologists applying for certification or recertification reported performing POP procedures during the study period - numbers of which increased steadily from 930 in 2003 to 6,978 in 2012. Colporrhaphies increased from 806 to 2670. Colpopexies increased steadily from 32 to 1414 during the study period. Vaginal colpopexies increased from 24 to 1016. Sacrocolpopexies rose from 8 to 398 with laparoscopic sacrocolpopexy showing exponential increases (282 cases by 2012). Mesh insertion rose from 10 in 2005 to 1552 in 2012 (p < 0.0005). Mesh revisions, first reported in 2007 with 52 performed, increased consistently to 214 in 2012. Urologists trained in female urology performed more POP procedures (17 more per year), as did female urologists (18 more per year), and those recertifying (6 more per year than initial certification).
Conclusions:
Urologist performed POP surgery has increased dramatically over the last decade with a similar rise in mesh usage. More colpopexies are now performed with laparoscopic sacrocolpopexy showing exponential increase. The recent trend of mesh revisions, which show much faster rate of increase than mesh insertions, is noteworthy.
Introduction and Objective:
Surgical correction of POP has undergone a transformation over the past decade. Training in POP surgery, ease of mesh kit use and FDA warnings on mesh have influenced practice patterns. We investigated trends in POP procedures.
Materials and Methods:
Data on POP procedures, mesh usage, pessary placement performed between 2003 and 2012 by certifying and recertifying urologists were obtained in the form of annualized case logs from the American Board of Urology (ABU). Associations between surgeon characteristics (type of certification, annual volume, practice type and location) and use of POP procedures were evaluated.
Results:
2192 out of 6,355 non-pediatric urologists applying for certification or recertification reported performing POP procedures during the study period - numbers of which increased steadily from 930 in 2003 to 6,978 in 2012. Colporrhaphies increased from 806 to 2670. Colpopexies increased steadily from 32 to 1414 during the study period. Vaginal colpopexies increased from 24 to 1016. Sacrocolpopexies rose from 8 to 398 with laparoscopic sacrocolpopexy showing exponential increases (282 cases by 2012). Mesh insertion rose from 10 in 2005 to 1552 in 2012 (p < 0.0005). Mesh revisions, first reported in 2007 with 52 performed, increased consistently to 214 in 2012. Urologists trained in female urology performed more POP procedures (17 more per year), as did female urologists (18 more per year), and those recertifying (6 more per year than initial certification).
Conclusions:
Urologist performed POP surgery has increased dramatically over the last decade with a similar rise in mesh usage. More colpopexies are now performed with laparoscopic sacrocolpopexy showing exponential increase. The recent trend of mesh revisions, which show much faster rate of increase than mesh insertions, is noteworthy.
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