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Text Version   RSS   Subscribe   Unsubscribe   Archive   Media Kit          October 17, 2014

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President's Perspective: Immediate Changes to the NCCI Edits — Could this be the Unintended Death of Vaginal Hysterectomy?
AUGS
AUGS leadership is and has been aware that CMS had vaginal hysterectomy in the crosshairs since they requested comments from us last summer. If you follow the links provided you will see that AUGS provided detailed critiques of these proposed edits. As these new changes affect us all, it is a very high priority for our organization to continue to refute these changes. We will be putting forth the action plan outlined below. Please inform yourselves and stay informed as we navigate these treacherous waters together.

The AUGS Coding Committee is our voice with the many agencies that oversee physician reimbursement. Frequently NCCI requests comments from AUGS about potential coding changes. This past summer AUGS provided comments concerning potential edits to select codes, ACOG also provided comments which underscored AUGS' comments. A copy of AUGS' comment letter and NCCI's response can be found here.
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AUGS HIGHLIGHTS


Relive the AUGS-IUGA 2014 Scientific Meeting on the AUGS Education Portal
AUGS
Visit the AUGS Education Portal to view material from the AUGS-IUGA 2014 Scientific Meeting, including the J. Marion Sims, Ulf Ulmsten, and Raymond A. Lee lectures, as well as scientific advancements, groundbreaking research, and technologies applicable in both surgical and non-surgical settings.
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Pelvic Floor Dialogues — Issue 7 Now Available
AUGS
Pelvic Floor Dialogues — Issue 7 is now available on VoicesforPFD.org. The newsletter is designed to update patients on the latest pelvic floor research and connect them to valuable resources.

Articles in Pelvic Floor Dialogues — Issue 7 include:
  • "Break Free From PFDs" During Bladder Health Awareness Week
  • Start Moving to Stop Going
  • Dueling Dual Incontinence
  • If Only We Could Pick Our Parents
  • A New Name for Menopause — Nope, it is Not Womenopause
A copy of the current issue, as well as past issues, can be viewed on VoicesforPFD.org. To subscribe or to request an email copy to send to your patients, please email info@augs.org.

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FPMRS ARTICLES


Validity and reliability of an instrumented speculum designed to minimize the effect of intra-abdominal pressure on the measurement of pelvic floor muscle strength
Clinical Biomechanics
Measurements of pelvic floor muscle strength are contaminated by crosstalk from intra-abdominal pressure. We tested an improved instrumented speculum designed to minimize this crosstalk. The hypotheses were that the speculum yields: 1) maximum vaginal closure forces unrelated to intra-abdominal pressure, 2) discriminatory validity between women with strong vs. weak pelvic floor muscles, and 3) acceptable test-retest reliability.
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Electronic pelvic floor assessment questionnaire: A systematic review
British Journal of Nursing
Quality of life can be seriously affected by pelvic floor disorders and a range of other coexisting symptoms. The electronic patient assessment questionnaire is a validated tool that can be used for the assessment of pelvic floor disorders. The authors aimed to systematically review all the studies that had used ePAQ for assessment of pelvic-floor-related quality of life.
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The effect of ascorbic acid and fluid flow stimulation on the mechanical properties of a tissue engineered pelvic floor repair material
Proceedings of the Institution of Mechanical Engineers, Part via PubMed
Synthetic non-degradable meshes used in pelvic floor surgery can cause serious complications such as tissue erosion. A repair material composed of an autologous oral fibroblast seeded degradable polylactic acid scaffold may be a viable alternative. The aims of this study were to investigate the effects of media supplementation with additives on the mechanical properties of these scaffolds. Oral fibroblasts were isolated from buccal mucosa.
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Reconstruction of the pelvic floor and the vagina after total pelvic exenteration using the transverse musculocutaneous gracilis flap
Journal of Plastic, Reconstructive & Aesthetic Surgery
Total pelvic exenteration is a rare operation in which the pelvic contents are removed entirely. Several options for pelvic floor and vaginal reconstruction have been described including transverse rectus abdominis musculocutaneous or deep inferior epigastric perforator flaps. The transverse musculocutaneous gracilis flap has been introduced for breast reconstruction as a free flap. We adopted the pedicled TMG flap for reconstructions after TPE. To the best of our knowledge, this is the first report of this method in the literature.
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President's Perspective: Immediate Changes to the NCCI Edits — Could this be the Unintended Death of Vaginal Hysterectomy?
AUGS
AUGS leadership is and has been aware that CMS had vaginal hysterectomy in the crosshairs since they requested comments from us last summer. If you follow the links provided you will see that AUGS provided detailed critiques of these proposed edits. As these new changes affect us all, it is a very high priority for our organization to continue to refute these changes.

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read more
The interaction of stress and urgency urinary incontinence and its effect on quality of life
International Urogynecology Journal via PubMed
We used data from the General Longitudinal Overactive Bladder Evaluation-UI study in women. Stress and urgency UI symptom severity scores ranged from 0 to 8. We used logistic regression to test the relation among different severity levels of stress and urgency UI, and their interaction with the Incontinence Impact Questionnaire. This was categorized according to percentage ranges as 0-40 percent, 41-80 percent, and 81-100 percent.

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Medtronic verify system to identify incontinence patients eligible for sacral neurostimulation
MedGadget
Urinary incontinence is an awkward and frustrating condition that people of all age groups can suffer from. There are some therapies in existence that can help deal with the condition, but choosing which route to take can be hit or miss. A popular solution that recently came to market involves using a neurostimulator to target the sacral nerves, which in turn contracts muscles within the pelvic floor.

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Current developments and perspectives on the diagnosis and treatment of urinary incontinence and genital prolapse in women
Geburtshilfe und Frauenheilkunde
As a key area of gynaecology, urogynaecology has undergone impressive changes in the past few years. Together with the high prevalence of functional pelvic floor disorders, modern anaesthesia procedures and the introduction of new, innovative minimally invasive operation techniques have led to a dramatic increase in the number of operations for incontinence and prolapses. The increasingly subtle diagnostic options, such as, e. g., 2D and 3D sonography of the pelvic floor provide unambiguous findings and facilitate decision making.
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FPMRS NEWSBRIEFS


Scientists are surprised to find an involuntary link in the brain between the pelvic floor and other muscles
Medical Xpress
Wherever you are right now: squeeze your glutes. Feel that? You just also contracted your pelvic floor too, whether you wanted to or not. Scientists studying the source of chronic abdominal and pelvic floor pain found an unexpected connection in the brain between the pelvic floor — the muscle responsible for, among other things, keeping you from peeing your pants — and various muscles throughout the body. They've found some evidence for a link as far away as the toes (try tapping a toe and see if you feel the clench), but the strongest link so far is with the glutes.
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Urinary incontinence is not just a normal part of aging
San Francisco Chronicle
Urinary incontinence affects an estimated 25 million people in the United States, most of them women. Although this diagnosis is not life-threatening, it does have important implications for health and overall well-being. Embarrassment and stigma cause many women to begin limiting activities such as exercise, travel and social events, making them vulnerable to depression. Incontinence has also been shown to increase the risk of falls and hip fractures, a significant cause of mortality in older adults, according to a study done by my colleague at UCSF, Dr. Judith Brown.
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Colby Horton, Vice President of Publishing, 469.420.2601
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Caitlin McNeely, Senior Editor, 469.420.2692  
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