MP07-09 TRENDS IN IMPLANTATION AND EXPLANTATION OF MESH FOR PELVIC ORGAN PROLAPSE AMONG FPMRS AND GENERAL UROLOGISTS

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP07-09 TRENDS IN IMPLANTATION AND EXPLANTATION OF MESH FOR PELVIC ORGAN PROLAPSE AMONG FPMRS AND GENERAL UROLOGISTS Mitchell G. Goldenberg, Unwanaobong Nseyo, Madeleine Burg, Evgeniy Kreydin, and David A. Ginsberg Mitchell G. GoldenbergMitchell G. Goldenberg More articles by this author , Unwanaobong NseyoUnwanaobong Nseyo More articles by this author , Madeleine BurgMadeleine Burg More articles by this author , Evgeniy KreydinEvgeniy Kreydin More articles by this author , and David A. GinsbergDavid A. Ginsberg More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003222.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The use of synthetic mesh in the treatment of pelvic floor conditions has long been scrutinized. Statements from multiple professional societies recommend that mesh for pelvic organ prolapse (POP) be performed only by those properly trained in both implantation and management of complications. We used case logs from the American Board of Urology (ABU) to understand temporal changes in the use of pelvic mesh among subspecialty trained and general urologists. METHODS: Case logs submitted to the ABU for certification and recertification in 2013 and in 2020 were reviewed. Demographic data including surgeon age, fellowship training, certification cycle, and practice type and location was analyzed. We analyzed trends in mesh insertion (both for POP and SUI) and mesh revision/removal based using common procedural terminology (CPT) codes among FPMRS and general urologists. Statistical analysis was performed using chi-squared test, binary regression, and Cronbach’s alpha. RESULTS: Over the two study years, 1877 surgeons contributed 253,326 unique procedures. A total of 1910 (1.8% of total cases) mesh implantation procedures were performed in 2013 compared to 2245 (1.5%) in 2020. Among FPMRS providers (n=154, 8.2%), the use of vaginal mesh for POP decreased from 4.6% to 1.5% (p<.001) of their total procedure volume, while transabdominal mesh for POP increased from 3.1% to 5.3%, (p<.001, see Figure 1). Similar changes were seen among generalists, among whom the rate tripled (0.1% to 0.4%, p<.001, see Figure 1b). Mesh revision/removal rates were stable (2.9%, p=.224) among FPMRS providers, but significantly decreased among general urologists in 2020 (0.2% to 0.1% p<.001). On multivariable analysis, generalists more likely to perform mesh revisions/removals were non-academic, female, and practiced in areas with a population density ≥1 million. Generalists implanting mesh were also more likely to perform revision/removal (Cronbach’s alpha=0.343, p=.015). CONCLUSIONS: Mesh-augmented POP repairs continue to be used among FPMRS and general urologists. However, these data indicate that general urologists may be referring mesh complications onto FPMRS providers, indicating that societal and FDA recommendations are perhaps not being adhered to. Source of Funding: The Catherine and Joseph Aresty Department of Urology © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e87 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mitchell G. Goldenberg More articles by this author Unwanaobong Nseyo More articles by this author Madeleine Burg More articles by this author Evgeniy Kreydin More articles by this author David A. Ginsberg More articles by this author Expand All Advertisement PDF downloadLoading ...