MedStar Authors catalog › Details for: Practice patterns of general gynecologic surgeons versus gynecologic subspecialists for concomitant apical suspension during vaginal hysterectomy for uterovaginal prolapse.
Citation: Southern Medical Journal. 108(1):17-22, 2015 Jan..Journal: Southern medical journal.ISSN: 0038-4348.Full author list: Yurteri-Kaplan LA; Mete MM; St Clair C; Iglesia CB.UI/PMID: 25580752.Subject(s): Adult | Aged | Databases, Factual | Female | Gynecologic Surgical Procedures/mt [Methods] | *Gynecology/sn [Statistics & Numerical Data] | Humans | *Hysterectomy, Vaginal/mt [Methods] | Middle Aged | *Physician's Practice Patterns/sn [Statistics & Numerical Data] | Reoperation/sn [Statistics & Numerical Data] | Retrospective Studies | *Uterine Prolapse/su [Surgery]Institution(s): MedStar Health Research Institute | MedStar Washington Hospital CenterDepartment(s): Obstetrics and Gynecology/Female Pelvic Medicine and Reconstructive Surgery | NursingActivity type: Journal Article.Medline article type(s): Comparative Study | Journal Article | Research Support, N.I.H., Extramural | Research Support, Non-U.S. Gov'tOnline resources: Click here to access onlineDigital Object Identifier: http://dx.doi.org/10.14423/SMJ.0000000000000222 (Click here)Abbreviated citation: South Med J. 108(1):17-22, 2015 Jan.Local Holdings: Available online through MWHC library: 2003 - present, Available in print through MWHC library: 1999 - 2006.Abstract: OBJECTIVES: We hypothesized that subspecialists perform more concomitant apical suspensions during transvaginal hysterectomy for uterovaginal prolapse as compared with general gynecologists.Abstract: METHODS: Retrospective analysis of the MedStar Health EXPLORYS database for women undergoing transvaginal hysterectomy for prolapse. Appropriate International Classification of Diseases-9 codes for uterine prolapse and incomplete and complete uterovaginal prolapse along with Current Procedural Terminology codes were used to determine frequency of transvaginal hysterectomy alone, transvaginal hysterectomy plus nonapical repair, and transvaginal hysterectomy plus concomitant apical suspension.Abstract: RESULTS: A total of 946 patients underwent vaginal hysterectomy for prolapse, with 5.5 years follow-up. Thirty-five percent (n = 334) underwent transvaginal hysterectomy alone, 20% (n = 184) underwent transvaginal hysterectomy plus nonapical repair, and 45% (n = 428) underwent transvaginal hysterectomy plus apical suspension. Seventy-two percent of patients operated on by general gynecologists compared with 4% of patients operated on by urogynecologists had a transvaginal hysterectomy alone. Only 10% of patients operated on by general gynecologic surgeons compared with 78% operated on by urogynecologists received a concomitant apical suspension for prolapse (P < 0.0001). Forty-four patients (4.7%) required repeat surgery for recurrent prolapse. Because of the small number of repeat surgeries, preoperative degree of prolapse and type of index procedure did not significantly affect the need for repeat surgery.Abstract: CONCLUSIONS: The majority of prolapse procedures involving hysterectomies performed by general gynecologists do not include apical suspension, whereas urogynecologic subspecialists consistently perform apical suspension.