ABSTRACT
Objective: Our department rapidly adopted a telemedicine option for outpatient evaluation of women with pelvic floor disorders during the pandemic. Our objective was to determine the proficiency of telemedicine in diagnosis of pelvic floor disorders and if an initial telemedicine visit impacted the rate of surgical management compared to an in-person evaluation. Methods: We performed a retrospective cohort study of all new patients referred to a single attending provider in female pelvic medicine at a tertiary care referral center who were seen via a telemedicine visit in the first 2 months of telehealth adoption during the COVID pandemic. New telemedicine patients were then compared to patients seen for a new in-person visit over the same time period the previous year. Via chart review, we collected demographic data, primary diagnoses rendered following visit completion and treatment (medical versus surgical) chosen. We compared the rate of surgical posting, number of visits from initial visit until the date of surgery, and rate of surgery cancellation in women seen for a pelvic floor disorder as a new in-person versus by telemedicine. Results: A total of 310 new patient visits were queried: 182 (59%) that took place in person between June 1 and July 30, 2019 and 128 via telemedicine over the same timeframe in 2020 (41%). Table 1 presents comparative demographic data, primary diagnoses and surgical procedures that resulted in each cohort. For women with a diagnosis of stress or mixed urinary incontinence, the rate of surgical posting for a sling procedure in-person- v. by telemedicine was 25% and 38%, P = 0.176. For women with a diagnosis of pelvic organ prolapse, the rate of surgical posting in-person v. by-telemedicine was 42% and 47%, P = 0.578. The median total number of outpatient visits required from initial visit to day of surgery was 2 in both groups, and the rate of surgery cancellation was 26% (in-person) and 12%(telemedicine), P = 0.168. Conclusions: New patient visits conducted via telemedicine resulted in similar rates of accurate surgical postings for both urinary incontinence and pelvic organ prolapse despite the absence of a pelvic examination. This data is useful for continuation of telemedicine platforms post pandemic.