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. 2023 Aug 1;29(8):660-669.
doi: 10.1097/SPV.0000000000001392.

Performance of Perioperative Tasks for Women Undergoing Anti-incontinence Surgery: Developed by the AUGS Quality Improvement and Outcomes Research Network

Elisabeth Erekson  1 , Emily L Whitcomb  2 , Neil Kamdar  3 , Steve Swift  4 , Geoffrey W Cundiff  5 , Jerome Yaklic  6 , Kris Strohbehn  7 , Rony Adam  8 , Jill Danford  9 , Marcella G Willis-Gray  10 , Rose Maxwell  11 , Autumn Edenfield  4 , Samantha Pulliam  12 , Merry Gong  13 , Mackenzie Malek  14 , Paul Hanissian  7 , Geoffrey Towers  11 , Noelani M Guaderrama  2 , Paul Slocum  15 , Daniel Morgan  3
Affiliations

Performance of Perioperative Tasks for Women Undergoing Anti-incontinence Surgery: Developed by the AUGS Quality Improvement and Outcomes Research Network

Elisabeth Erekson et al. Urogynecology (Phila). .

Abstract

Objectives: Surgery for the correction of stress urinary incontinence is an elective procedure that can have a dramatic and positive impact on quality of life. Anti-incontinence procedures, like inguinal hernia repairs or cholecystectomies, can be classified as high-volume/low-morbidity procedures. The performance of a standard set of perioperative tasks has been suggested as one way to optimize quality of care in elective high-volume/low-morbidity procedures. Our primary objective was to evaluate the performance of 5 perioperative tasks-(1) offering nonsurgical treatment, (2) performance of a standard preoperative prolapse examination, (3) cough stress test, (4) postvoid residual test, and (5) intraoperative cystoscopy for women undergoing surgery for stress urinary incontinence-compared among surgeons with and without board certification in female pelvic medicine and reconstructive surgery (FPMRS).

Study design: This study was a retrospective chart review of anti-incontinence surgical procedures performed between 2011 and 2013 at 9 health systems. Cases were reviewed for surgical volume, adverse outcomes, and the performance of 5 perioperative tasks and compared between surgeons with and without FPMRS certification.

Results: Non-FPMRS surgeons performed fewer anti-incontinence procedures than FPMRS-certified surgeons. Female pelvic medicine and reconstructive surgery surgeons were more likely to perform all 5 perioperative tasks compared with non-FPMRS surgeons. After propensity matching, FPMRS surgeons had fewer patients readmitted within 30 days of surgery compared with non-FPMRS surgeons.

Conclusions: Female pelvic medicine and reconstructive surgery surgeons performed higher volumes of anti-incontinence procedures, were more likely to document the performance of the 5 perioperative tasks, and were less likely to have their patients readmitted within 30 days.

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