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The Women's Continence and Pelvic Health Center at Cedars-Sinai Medical Center is a multidisciplinary care team including specialists from urogynecology, urology, colorectal surgery, gynecology, and gastroenterology. Our goal is to provide comprehensive diagnostic and treatment services for women who suffer from disorders associated with the female pelvic floor, including:
- Urinary incontinence
- Urinary frequency and urgency
- Pelvic organ prolapse
- Rectal prolapse
- Difficulty in bladder or bowel emptying
- Fecal incontinence
- Painful bladder syndrome
- Recurrent urinary tract infections
Surgical treatments performed for some of the conditions above include:
- Suburethral slings
- Vaginal vault suspension and enterocele repair
- Hysterectomy (when indicated)
- Cystocele or rectocele repair
- Insertion of the interstim sacral nerve implant
- Injection of periurethral bulking agents
- Anal sphincter repair
- Colon resection (when indicated)
These operations may be done transvaginally or transrectally, laparoscopically or with an incision. Surgeons at the Cedars-Sinai Center for Women's Continence and Pelvic Health choose the least invasive option that is safe and appropriate for the patient.
Measuring the Quality of Care at the Cedars-Sinai Center for Women's Continence and Pelvic Health
At the Cedars-Sinai Center for Women's Continence and Pelvic Health, a variety of factors are monitored to measure the quality of care available to patients including:
- Board certification. To be board certified, the physician has been subject to both written and oral examinations that ensure that his or her breadth of knowledge and reasoning skills are on par with other physicians in each field of specialization. All members of the Cedars-Sinai Center for Women's Continence and Pelvic Health are board certified.
- Total volumes of procedures. Studies Studies suggest that for many surgical procedures, hospitals that perform high volumes have better quality outcomes, i.e. lower short-term and long term mortality and morbidity. Volume is an indicator of experience, which influences outcomes in multiple ways. In addition to the experience of surgeons in performing specific procedures, high volume hospitals may institute specific care processes that improve outcomes and have the infrastructure dedicated to particular clinical specialties, including related technology and intensive care personnel. Commitment to quality standards throughout the institution is also an important determinant of better outcomes.1,2 In addition, outcomes for high-risk procedures have been shown to be better when performed by more highly-trained surgeons than by general surgeons.3
|Vaginal vault suspension||18||26||27|
- Comparing Outpatient and Inpatient Suburethral Sling Rates. As detailed in the chart below, Cedars-Sinai's CWCPH physicians perform the majority of the suburethral slings in the outpatient setting, which eliminates inpatient hospital admission and helps patients get back to their lives sooner.
|Percent Outpatient vs Inpatient||2012||2013||2014|
- Average length of stays (ALOS). This refers to the average number of days a patient stays at Cedars-Sinai Medical Center after being admitted. The goal is to ensure that all patients are appropriately treated in the hospital for their respective conditions and are not hospitalized longer than they should be. Suburethral sling procedures and vaginal vault suspension are often done in conjunction with other surgeries such as bladder suspension, rectocele repair and hysterectomy when indicated, lengthening the hospital stay. As detailed in the chart below, in-patient suburethral slings and vaginal vault suspensions performed by Cedars-Sinai’s CWCPH physicians result in a length of stay that is consistent with what would be expected for a clinically similar population,
|Average Length of Stay
Patients Discharged in 2014
|Suburethral sling||4.35 days||4.36 days|
|Vaginal vault suspension||1.67 days||1.70 days|
- Mortality. This data compares actual patient deaths to the number of deaths which would be expected for a clinical similar patient population, and suggests that patients treated at Cedars-Sinai have a higher survival rate than expected.
|Deaths of Patients
Discharged in 2014
|Vaginal vault suspension||0%||0%|
The data comes from the University HealthSystem Consortium (UHC), an alliance of more than 300 of the nation’s non-profit academic medical centers and their affiliated hospitals. The majority of these facilities participate in UHC's Clinical DataBase/Resource Manager. The information reflects all patients discharged January 1 - December 31, 2014. The data was accessed on April 4, 2015.
1Bach PB, Ann Intern Med 2009; 150:729-30
2Greene FL, Ann Surg Oncol 2007; 15:14-15
3Kozower BD et al, Ann Thorac Surg 2008; 86:1405-08