title: Pelvic Organ Prolapse Surgery in Academic Female Pelvic Medicine and Reconstructive Surgery Urology Practice in the Setting of the Food and Drug Administration Public Health Notifications.
abstract: To understand the effect of the Food and Drug Administration (FDA) public health notifications regarding transvaginal placement of surgical mesh for pelvic organ prolapsed (POP) on surgeon practice patterns in tertiary care academic medical centers.
  
  
  
  Surgical volume for procedures performed primarily by fellowship trained Female Pelvic Medicine and Reconstructive Surgery at a sampling of 8 academic institutions across the US were collected using current procedural technology codes for POP repair and revision surgeries from 2007 to 2013. SAS statistical software was used to analyze data for trends and to assess differences in number of procedures across years by performing Spearman correlation analysis and Pearson's chi-squared test. Significance of trend was defined as P <.05 for both analysis methods.
  
  
  
  There has been a substantial reduction in transvaginal mesh-augmented repair of POP since the FDA warning statements of 2008 and 2011. Mesh revision surgery has increased over this same period. However, the total number of interventions for POP has remained stable over the study period. Abdominal sacrocolpopexy has increased as a whole but represents only a small percentage of total cases.
  
  
  
  Surgical correction of POP comprises a large portion of Female Pelvic Medicine and Reconstructive Surgery practice that continues to evolve in the aftermath of the FDA public health notifications. The utilization of transvaginal placement of surgical mesh augmented POP repair has decreased among practicing urologists at a sampling of academic institutions across the United States. Indications for surgery, complications, and outcomes were not evaluated during this retrospective study; however, such data may provide alternative insights into the reasons for the observed trends.
authors: Department of Urology, Medical University of South Carolina, Charleston, SC.
authors: Austin
authors: A
authors: Younger
authors: Department of Urology, Medical University of South Carolina, Charleston, SC.
authors: Goran
authors: G
authors: Rac
authors: Department of Urology, University of Michigan Health Science Center, Ann Arbor, MI.
authors: J Quentin
authors: JQ
authors: Clemens
authors: Section of Urology and Renal Transplantation, Virginia Mason Medical Center, Seattle, WA.
authors: Kathleen
authors: K
authors: Kobashi
authors: Department of Urology, New York University Langone Medical Center, New York, NY.
authors: Aqsa
authors: A
authors: Khan
authors: Department of Urology, New York University Langone Medical Center, New York, NY.
authors: Victor
authors: V
authors: Nitti
authors: Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX.
authors: Ilana
authors: I
authors: Jacobs
authors: Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX.
authors: Gary E
authors: GE
authors: Lemack
authors: Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN.
authors: Elizabeth T
authors: ET
authors: Brown
authors: Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN.
authors: Roger
authors: R
authors: Dmochowski
authors: Institute of Urology, Lahey Hospital & Medical Center, Burlington, MA.
authors: Lara
authors: L
authors: Maclachlan
authors: Institute of Urology, Lahey Hospital & Medical Center, Burlington, MA.
authors: Arthur
authors: A
authors: Mourtzinos
authors: Institute of Urology, Keck Medicine of University of Southern California, Los Angeles, CA.
authors: David
authors: D
authors: Ginsberg
authors: Urology of Kaiser Permanente Medical Center, San Diego, CA.
authors: Michelle
authors: M
authors: Koski
authors: Department of Urology, Medical University of South Carolina, Charleston, SC.
authors: Ross
authors: R
authors: Rames
authors: Department of Urology, Medical University of South Carolina, Charleston, SC. Electronic address: rovnere@musc.edu.
authors: Eric
authors: E
authors: Rovner
mesh_terms: D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods / Q000639:trends; D006801:Humans; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D010818:Practice Patterns, Physicians'; D011634:Public Health; D012189:Retrospective Studies; D013526:Surgical Mesh; D014481:United States; D014486:United States Food and Drug Administration; D013520:Urologic Surgical Procedures / Q000379:methods / Q000639:trends