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Ob.Gyns. Don't Always Perform Cystoscopy

Major Finding: Ninety-five percent of survey respondents reported that they routinely perform cystoscopy after doing a retropubic midurethral sling procedure; 82%, after placing a transobturator midurethral sling; 81%, after placing a retropubic pubovaginal sling; and 74%, after doing a Burch bladder neck suspension. Only 46% reported performing cystoscopy after doing a uterosacral ligament suspension; 29%, after a McCall’s culdoplasty; and 34%, after an anterior repair.

Data Source: The researchers conducted a cross-sectional survey about the management of stress urinary incontinence and POP with a random sample of 3,225 ob.gyns. A total of 261 physicians responded (8% response rate).

Disclosures: Dr. Estanol and her associates reported that they had no relevant financial disclosures.


 

FROM THE ANNUAL MEETING OF THE SOCIETY OF GYNECOLOGIC SURGEONS

BALTIMORE – Obstetrician/gynecologists frequently use mesh kits for pelvic organ prolapse repair, although a considerable number do not routinely perform cystoscopy after prolapse repair, a survey of 261 physicians has shown.

In the study, almost three-quarters (72%) of the 261 respondents reported using anterior, posterior, or total mesh kits, reported Dr. Maria Estanol, who is a second-year fellow in female pelvic medicine and reconstructive surgery at Good Samaritan Hospital in Cincinnati.

After performing a retropubic midurethral sling, 95% reported performing cystoscopy. However, the numbers declined with other procedures: 82% performed cystoscopy after placing a transobturator midurethral sling; 81%, after placing a retropubic pubovaginal sling; and 74%, after doing a Burch bladder neck suspension. Only 46% reported performing cystoscopy after doing a uterosacral ligament suspension; 29%, after McCall’s culdoplasty; and 34%, after an anterior repair.

These were the findings from a cross-sectional survey of a random sample of 3,225 ob.gyns. The researchers used the American Medical Association’s physician database to identify potential participants. The sample was equally distributed for sex, geographical location of practice, and age group. Subspecialists were excluded. The researchers asked participants to answer a 32-item, Internet-based questionnaire about the management of stress urinary incontinence and pelvic organ prolapse (POP), Dr. Estanol reported at the annual meeting of the Society of Gynecologic Surgeons.

A total of 261 physicians responded (8% response rate). Roughly one-third of participants were between 41 and 60 years of age. The remaining two-thirds were 31-40 years of age or older than 60 years. Almost half (45%) of the physicians had been in practice more than 20 years. About two-thirds were male, and approximately two-thirds were in private practice.

Of the respondents, 54% reported performing urodynamics in their practice, and 57% reported doing residency training in urodynamics. Most (81%) reported performing surgery for stress incontinence. Three-quarters had performed transobturator midurethral sling procedures, 73% had performed retropubic midurethral sling procedures, and 69% had performed Burch bladder neck suspension procedures as treatments for stress urinary incontinence.

Almost all (99%) reported managing POP (surgical or medical), and 88% reported performing surgery for POP. Ninety-three percent reported doing residency surgical training for prolapse.

The meeting was jointly sponsored by the American College of Surgeons.

Dr. Estanol and her associates reported that they had no relevant financial disclosures.

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