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Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Int+Urogynecol+J 2015 ; 26 (12): 1797-801 Nephropedia Template TP
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Perineorrhaphy: Commonly performed yet poorly understood; a survey of surgeons #MMPMID26142348
Gregory; Jeppson PC; McGuire BL; Rogers RG
Int Urogynecol J 2015[Dec]; 26 (12): 1797-801 PMID26142348show ga
Introduction and Hypothesis: Perineorrhaphy is performed for prevention of recurrent prolapse, improved sexual function, treatment of pain and cosmesis. Its use is based on expert opinion with little objective data. We aimed to describe factors important to surgeons when deciding to perform perineorrhaphy and to describe variations in surgical technique. Methods: We administered an anonymous survey to surgeon attendees at the 2014 SGS annual scientific meeting regarding which factors are important when deciding to perform a perineorrhaphy and details of their surgical technique. Surgeons rated the importance of factors; 1-way ANOVA was used to rank the decision factors, post hoc pairwise comparisons with Fisher's least significant difference method were used to evaluate the importance between factors. Results: 183/360 surgeon attendees responded. Most were between ages 36-60 (79%), 56% were female, 64% practiced in an academic environment and 64% had undergone subspecialty training. An enlarged genital hiatus (GH) ranked as the most important factor influencing the decision to perform a perineorrhaphy, followed by a concomitant prolapse procedure (p<0.001). Sexual function and cosmesis were rated less important. Decision to perform perineorrhaphy was made with the patient in 65% of cases, and otherwise in the operating room. Significant heterogeneity exists regarding surgeon suture preference and how muscles were re-approximated. Most (81%) reported incorporating structures both proximal and distal to the hymen in their repairs. Conclusion: GH size and concomitant prolapse procedures ranked highest in surgeons? decision to perform a perineorrhaphy. Significant heterogeneity exists in the indications for and technique used to perform perineorrhaphy.