Female Pelvic Med Reconstr Surg 2016 Jan-Feb;22(1):7-10
From the *Division of Urogynecology, Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA; †Division of Urogynecology, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI; ‡Division of Urogynecology, Department of Obstetrics and Gynecology, Southern California Permanente Medical Group, Irvine, CA; §Division of Statistics, School of Public Health, University of Michigan, Ann Arbor, MI; and ∥Division of Urogynecology, Department of Obstetrics and Gynecology, Vanderbilt University, Nashville, TN.
Objective: The aim of the study was to determine whether surgeon case volume is associated with preoperative evaluation of pelvic organ prolapse before a hysterectomy for uterovaginal prolapse including a complete objective evaluation of prolapse (Baden-Walker or Pelvic Organ Prolapse Quantification), an offer of nonsurgical options for therapy (pessary), and a preoperative assessment of urinary incontinence
Methods: We performed a multicenter retrospective review of hysterectomies done for uterovaginal prolapse at 4 hospital systems between January 1, 2008 and December 31, 2011. The number of hysterectomies per surgeon for 4 years was evaluated to establish low-volume (≤10 cases), intermediate-volume (11-49 cases), and high-volume (≥50 cases) groups. Rates of preoperative standardized prolapse evaluations, offer of pessary, and evaluation of stress urinary incontinence were determined by chart review of 15% of the hysterectomy cases. Read More