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Changing Referral Patterns to Urogynecology

Geynisman-Tan, Julia, MD; Brown, Oluwateniola, MD; Mueller, Margaret, MD; Leader-Cramer, Alix, MD; Dave, Bhumy, MD; Bochenska, Katarzyna, MD; Collins, Sarah, MD; Lewicky-Gaupp, Christina, MD; Kenton, Kimberly, MD, MS

Female Pelvic Medicine & Reconstructive Surgery: January/February 2018 - Volume 24 - Issue 1 - p 48–50
doi: 10.1097/SPV.0000000000000416
Original Articles

Objective The study aims to identify sources of and changes in referral patterns for pelvic floor disorders.

Methods All new patient visits to urogynecology at our institution between January 2010 and December 2015 were identified. Patient demographics, referral source, insurance type, and visit diagnoses using ICD-9 codes were abstracted. ICD-9 codes were grouped into 18 urogynecologic diagnoses. Data were analyzed using SPSS (Version 20; Chicago, IL).

Results Five thousand seven hundred ninety-nine new patient visits were included in the analysis. The mean age was 54 ± 17 years and 59% were Caucasian. Forty-four percent were referred by obstetrician/gynecologists (OB/GYNs), 32% by primary care providers (PCPs), 14% by self-referral, and 9% by other specialties. New patient visits increased overall by 280% over 6 years; self- and PCP referrals increased by 480% and 320%, respectively. In comparison, OB/GYN referrals increased by only 229%. Patients diagnosed with prolapse and stress incontinence were more likely to be referred by an OB/GYN (P < 0.001), whereas PCPs were more likely to refer for urinary tract infections (P < 0.005) and urgency urinary incontinence (P < 0.001) than OB/GYNs.

Conclusions Demand for pelvic floor specialists is growing quickly, with PCP and self-referrals outpacing referrals from obstetrician-gynecologists to tertiary care urogynecology practices.

A study of changing referral patterns to Urogynecology.

From the Division of Female Pelvic Medicine and Reconstructive Surgery, Northwestern University, Chicago, IL.

Reprints: Julia Geynisman-Tan, MD, 250 E Superior St, Suite 03–2302, Chicago, IL. E-mail:

Kimberly Kenton, MD, MS, has grant funding from Boston Scientific. The remaining authors have declared they have no conflicts of interest.

Institutional review board approved on July 21, 2016 by the Northwestern University. Institutional review board approval no. STU00203562.

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