E-Posters-Technique and Approach for Apical Pelvic Organ Prolapse Repair: A 10-year Statewide Analysis

Technique and Approach for Apical Pelvic Organ Prolapse Repair: A 10-year Statewide Analysis - Michael D. Gross, MD

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This study analyzed trends in the use of apical pelvic organ prolapse repair techniques in New York State from 2006 to 2015. The researchers used the Statewide Planning and Research Cooperative System (SPARCS) database to collect data on surgeries performed in ambulatory surgical centers and transvaginal vault suspensions. Surgeries were identified using CPT codes.<br /><br />The study aimed to assess the impact of the 2011 FDA safety communication warning against the use of mesh in urogynecologic procedures on trends in sacrocolpopexy (ASC) compared to transvaginal vault suspension (TVS). The researchers also wanted to examine differences in fellowship training among urologists and gynecologists in performing these procedures.<br /><br />The findings showed that the number of ASC procedures initially decreased after the FDA communication, but rebounded due to increased uptake by fellowship-trained physicians. TVS remained more common than ASC for apical pelvic organ prolapse repair, but the trend was narrowing.<br /><br />During the study period, a total of 2235 ASC cases (35.4%) and 4070 TVS cases (64.6%) were performed. The majority of ASC procedures were done laparoscopically. The number of ASC and TVS procedures increased at an average rate of 41% and 24% per year, respectively.<br /><br />There was a significant increase in ASC performed by fellowship-trained physicians after the FDA communication, while there was a significant decrease in ASC performed by non-fellowship providers.<br /><br />In conclusion, the study revealed changing trends in the use of apical pelvic organ prolapse repair techniques in New York State. The use of ASC increased among fellowship-trained providers, while TVS remained the more common approach. Further research is needed to understand these trends better.

Keywords

apical pelvic organ prolapse repair

trends

New York State

SPARCS database

transvaginal vault suspension

CPT codes

FDA safety communication

mesh

sacrocolpopexy

fellowship training