Urogynecology

Urogynecology

Unless otherwise specified, outcomes reported here reflect care by gynecology staff practicing
in Cleveland Clinic facilities in northeast Ohio.

Surgical Case Approach

2014 − 2018

Adverse Events Within 30 Days of Urogynecologic Surgery

2015 − 2018

ᵃTotal number of urogynecologic surgical procedures per year

Three-Year Prolapse Reoperation Percentage

2009 – 2017

Between 2009 and 2017, 2198 patients underwent prolapse surgery and had at least 1 year of follow-up. The figure illustrates the percentage of these patients who had a reoperation for prolapse relative to the time of their initial surgery. The number of patients at risk represents those patients with the indicated length of follow-up who did not have a prolapse reoperation. The 3-year prolapse reoperation rate for Cleveland Clinic urogynecologic surgeons is approximately 2.5%.

Five-Year Prolapse Reoperation Percentage

2009 - 2017

Between 2009 and 2017, 2198 patients underwent prolapse surgery and had at least 1 year of follow-up. The figure at left illustrates the percentage of these patients who had a reoperation for prolapse relative to the time of their initial surgery. The number of patients at risk represents those patients with the indicated length of follow-up who did not have a prolapse reoperation. The 5-year prolapse reoperation rate for Cleveland Clinic urogynecologic surgeons is approximately 3.0%.

Three-Year Sling Revision Rate

2009 – 2017

Between 2009 and 2017, 2357 patients received incontinence (sling) surgery and had at least 1 year of follow-up. The figure illustrates the percentage of these patients who had sling revision urethrolysis relative to the time passed after their initial surgery. The number of patients at risk represents those patients with the indicated length of follow-up who have not had sling revision. The 3-year sling revision rate for Cleveland Clinic urogynecologic surgeons is 2.5%.

Urinary Incontinence Procedures Following Sacrospinous Fixation, Uterosacral Suspension, and Minimally Invasive Sacrocolpopexy

2009 – 2018

  • A total of 269 patients underwent minimally invasive abdominal sacrocolpopexy. Using survival modeling, the cumulative incidence for transurethral bulking or midurethral sling placement (with adjustment for loss to follow-up) was 6.5% over 3 years.
  • A total of 424 patients underwent sacrospinous fixation. Using survival modeling, the cumulative incidence for transurethral bulking or midurethral sling placement (with adjustment for loss to follow-up) was 3.7% over 3 years.
  • A total of 781 patients underwent uterosacral ligament vaginal vault suspension. Using survival modeling, the cumulative incidence for transurethral bulking or midurethral sling placement (with adjustment for loss to follow-up) was 3.0% over 3 years.
Thirty-Day Readmission Rate Following Inpatient Urogynecologic Surgeryᵃ

2015 – 2018

ᵃThese data are prepared using the Vizient Clinical Database. Data from the Vizient Clinical Data Base/Resource Manager™ used by permission of Vizient. All rights reserved.

ᵇBenchmark derived from review of peer organization members of Vizient for surgical cases performed for MS-DRGs 748, 749, and 750. Data from the Vizient Clinical Data Base/Resource Manager™ used by permission of Vizient. All rights reserved.

ᶜBeginning in 2014, the number of inpatient admissions was reduced due to payer reclassification of the majority of major surgery admissions to outpatient status (less than a 2 midnight stay). Patients meeting criteria for inpatient admission had more complex surgeries and more comorbidities than patients meeting criteria for discharge at less than a 2 midnight stay.

Length of Stay Following Inpatient Urogynecologic Surgeryᵃ

2015 – 2018

LOS = length of stay

ᵃThese data are prepared using the Vizient Clinical Database. Data from the Vizient Clinical Data Base/Resource Manager™ used by permission of Vizient. All rights reserved.

ᵇTotal number of surgical cases performed for MS-DRGs 748, 749, and 750. Beginning in 2014, the number of inpatient admissions was reduced due to payer reclassification of the majority of major surgery admissions to outpatient status (less than a 2 midnight stay). Patients meeting criteria for inpatient admission had more complex surgeries and more comorbidities than patients meeting criteria for discharge at less than a 2 midnight stay.

Mona Lisa Cases

2016-2018

We have been performing the Mona Lisa Procedures since July 2015. Since that time we have performed xxx procedures with very few adverse events, all temporary. Our multi-center prospective trial that was recently submitted to “Menopause” showed that the Mona Lisa CO2 fractional laser therapy was non-inferior to vaginal estrogen for the indication of genitourinary syndrome of menopause at 6 months of follow-up.