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Stress urinary incontinence surgery trends in academic female pelvic medicine and reconstructive surgery urology practice in the setting of the food and drug administration public health notifications
Author(s) -
Rac Goran,
Younger Austin,
Clemens James Q.,
Kobashi Kathleen,
Khan Aqsa,
Nitti Victor,
Jacobs Ilana,
Lemack Gary E.,
Brown Elizabeth T.,
Dmochowski Roger,
MacLachlan Lara,
Mourtzinos Arthur,
Ginsberg David,
Koski Michelle,
Rames Ross,
Rovner Eric S.
Publication year - 2017
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.23080
Subject(s) - medicine , sling (weapon) , urinary incontinence , reconstructive surgery , food and drug administration , current procedural terminology , stress incontinence , surgical mesh , health care , general surgery , surgery , pelvic floor , urinary retention , hernia , environmental health , economics , economic growth
Aims To investigate the possible effects of the Food and Drug Administration (FDA) Public Health Notifications in 2008 and 2011 regarding surgical trends in transvaginal mesh (TVM) placement for stress urinary incontinence (SUI) and related mesh revision surgery in Female Pelvic Medicine & Reconstructive Surgery (FPMRS) practice in tertiary care academic medical centers in the United States. Methods Surgical volume for procedures performed primarily by FPMRS surgeons at eight academic institutions across the US was collected using Current Procedural Terminology (CPT) codes for stress urinary incontinence repair and revision surgeries from 2007 to 2013. SAS statistical software was used to assess for trends in the data. Results There was a decrease in the use of synthetic mesh sling for the treatment of SUI at academic tertiary care centers over the past 7 years; however, this was not statistically significant. While the total number of surgical interventions for SUI remained stable, there was an increase in the utilization of autologous fascia pubovaginal slings (AFPVS). The number of mesh sling revision surgeries, including urethrolysis and removal or revision of slings, increased almost three‐fold at these centers. Conclusions These observed trends suggest a possible effect of the FDA Public Health Notifications regarding TVM on surgical practice for SUI in academic centers, even though they did not specifically warn against the use of synthetic mesh for this indication. Indications for surgery, complications, and outcomes were not evaluated during this retrospective study. However, such data may provide alternative insights into reasons for the observed trends. Neurourol. Urodynam. 36:1155–1160, 2017 . © 2016 Wiley Periodicals, Inc.