TY - JOUR
T1 - Trends of Mesh Utilization for Stress Urinary Incontinence Before and After the 2011 Food and Drug Administration Notification Between FPMRS-Certified and Non-FPMRS-Certified Physicians
T2 - A Statewide All-Payer Database Analysis
AU - Siegal, Alexandra R.
AU - Huang, Zhenyue
AU - Gross, Michael D.
AU - Mehraban-Far, Sina
AU - Weissbart, Steven J.
AU - Kim, Jason M.
N1 - Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2021/4
Y1 - 2021/4
N2 - Objectives: To investigate the utilization of mesh slings for stress urinary incontinence (SUI) across time – before and after the 2011 US Food and Drug Administration (FDA) public health notification regarding an increase in adverse events related to transvaginal mesh (TVM) for pelvic organ prolapse (POP) repair – and among FPMRS-certified urologists and gynecologists and non-FPMRS counterparts using a statewide database. Methods: The New York Statewide Planning and Research Cooperative System all-payer database was utilized to extract outpatient Current Procedural Terminology procedure codes for SUI mesh sling utilization and revision or removal performed between 2007 and 2015. Results: After the 2011 FDA warning on POP with TVM, sling placement decreased by 43% from 5214 cases in 2011 to 2958 in 2015. However, over the study period, the rate of sling revision remained stable relative to total sling placement. The rise and fall in mesh sling usage for SUI was primarily driven by non-FPMRS providers. FPMRS providers performed a higher proportion of sling procedures. The number of FPMRS physicians also increased from 2011 to 2015, and each individual physician had a higher median case volume for sling placements and revisions. Conclusion: In New York state, utilization of mesh slings for SUI has significantly decreased since the 2011 FDA public health notification, without any specific warning for the utilization of mesh in this setting. This trend was mainly driven by a decrease in mesh usage among non-FPMRS physicians, although the specific causality is likely complex.
AB - Objectives: To investigate the utilization of mesh slings for stress urinary incontinence (SUI) across time – before and after the 2011 US Food and Drug Administration (FDA) public health notification regarding an increase in adverse events related to transvaginal mesh (TVM) for pelvic organ prolapse (POP) repair – and among FPMRS-certified urologists and gynecologists and non-FPMRS counterparts using a statewide database. Methods: The New York Statewide Planning and Research Cooperative System all-payer database was utilized to extract outpatient Current Procedural Terminology procedure codes for SUI mesh sling utilization and revision or removal performed between 2007 and 2015. Results: After the 2011 FDA warning on POP with TVM, sling placement decreased by 43% from 5214 cases in 2011 to 2958 in 2015. However, over the study period, the rate of sling revision remained stable relative to total sling placement. The rise and fall in mesh sling usage for SUI was primarily driven by non-FPMRS providers. FPMRS providers performed a higher proportion of sling procedures. The number of FPMRS physicians also increased from 2011 to 2015, and each individual physician had a higher median case volume for sling placements and revisions. Conclusion: In New York state, utilization of mesh slings for SUI has significantly decreased since the 2011 FDA public health notification, without any specific warning for the utilization of mesh in this setting. This trend was mainly driven by a decrease in mesh usage among non-FPMRS physicians, although the specific causality is likely complex.
UR - http://www.scopus.com/inward/record.url?scp=85088956351&partnerID=8YFLogxK
U2 - 10.1016/j.urology.2020.06.053
DO - 10.1016/j.urology.2020.06.053
M3 - Article
C2 - 32663554
AN - SCOPUS:85088956351
SN - 0090-4295
VL - 150
SP - 151
EP - 157
JO - Urology
JF - Urology
ER -