(Poster 147) Collaboration Between MIGS & Urogynecology Specialists on Joint Operating Cases

Objectives: To evaluate the extent of collaboration between minimally invasive gynecologic surgeons (MIGS) and urogynecologists, identifying barriers and opportunities for improvement, given the need for multidisciplinary involvement in managing complex patients.

Methods: This is a cross-sectional study conducted by distributing a 15-question survey to both MIGS and Urogynecology faculty members at 27 institutions that have both MIGS and Urogynecology fellowship training programs. Responses were de-identified and descriptive statistical analysis was performed.

Results: Preliminary data from the survey study was analyzed. Among 29 respondents (62.07% urogynecologists, 34.48% MIGS), 62.07% had 4-8 years of experience in their respective field and an overwhelming majority (89.66%) were from academic centers. Most respondents practiced in the Northeast (51.72%).

Of the respondents, greater than 60% of participants reported performing 5 or fewer joint cases with the other respective specialty in the last 12 months. In a 3-month timeframe, providers only occasionally (34.48%) or sometimes (27.58%) referred patients to the other specialty. Respondents reported that joint cases that were performed were done for complex patients (79.31%), referrals from other providers (48.28%) and, patient preference (48.28%). MIGS specialists identified the need for concomitant vaginal repairs (80%) and mid-urethral slings (100%) as the most common urogynecology cases of collaboration, while urogynecologists identified complex hysterectomies (72.22%), myomectomy (55.56%) and endometriosis excisions (61.11%) as MIGS cases of collaboration. Most respondents (62.7%) believed collaboration significantly improves patient satisfaction. Key barriers included scheduling conflicts (79.31%) and limited operating room (OR) availability (48.28%), see Figure 1a. Facilitators included improved scheduling (82.76%), recognition of multidisciplinary care (55.17%), and financial incentives (55.17%), see Figure 1b. Impact of joint cases on patient outcome was seen overwhelmingly as Very Positive or Positive (>90%) and 62.07% reported improved patient satisfaction.

Conclusions: MIGS providers and urogynecologists often manage medically complex patients with multiple comorbidities, necessitating the expertise of both specialists in the OR. While collaboration between MIGS and urogynecologists is recognized as beneficial, particularly for complex patients, it remains infrequent. Enhancing scheduling efficiency, facilitating referrals, and introducing incentives for multidisciplinary care can foster greater cooperation. More frequent referrals between MIGS and urogynecology specialists can further strengthen patient outcomes and interdisciplinary synergy.

Legends:
Figure 1a. Barriers to collaboration in joint MIGS-Urogynecology cases, with scheduling conflicts (79.31%) and resource/OR availability (48.28%) as the most frequently cited challenges.

Figure 1b. Factors enhancing joint case potential include coordination/scheduling improvements (82.76%), financial incentives (55.17%) and recognition of multidisciplinary care (55.17%) as the primary facilitators.