eP627 - Enhancing Care for Patients with Pelvic Floor Disorders; Insights from Multidisciplinary Meetings

Author(s)

• NA

  Nouf Akeel, M.D

  Associate professor of surgery
  King Abdulaziz University
  Jeddah, Makkah, Saudi Arabia

  Disclosure information not submitted.
• 

  Brooke Gurland, MD, FACS, FASCRS

  Clinical Professor of Surgery
  Stanford University
  Stanford Surgery
  Stanford, California, United States

  All relevant financial disclosures have been managed and will be listed below.
  This individual has no relevant relationships with ineligible companies.
• KM

  Kavita Mishra, M.D.

  Clinical Assistant Professor
  Stanford University
  Stanford, California, United States

  Disclosure information not submitted.
• EE

  Ekene Enemchukwu, MD, MPH

  Assistant Professor
  Stanford University, Department of Urology
  Palo Alto, California, United States

  Disclosure information not submitted.
• DA

  Diana Atashroo, MD

  Associated Professor of Obstetrics and Gynecology
  Stanford University
  San Carlos, California, United States

  Disclosure information not submitted.

ePoster Presenter(s)

• 

  Sydni Au Hoy, BS (she/her/hers)

  Assistant Clinical Research Coordinator
  Stanford University
  Stanford University
  Palo Alto, CA, United States

  All of the relevant financial relationships listed below have been mitigated.
  This individual has no financial relationships with ineligible companies.

Author(s)

• JB

  Julia Barten, DPT, PRPC

  Physical Therapist
  Stanford Health Care
  East Palo Alto, California, United States

  Disclosure information not submitted.

Senior Author(s)

• LN

  Leila Neshatian, MD, Msc

  Clinical Associate Professor
  Stanford University
  Redwood City, California, United States

  Disclosure information not submitted.

Author(s)

• 

  Vipul R. Sheth, MD

  Disclosure information not submitted.

Purpose/Background: The multidisciplinary approach to pelvic floor disorders is fundamental and has been shown to improve patient care outcomes. Nevertheless, multidisciplinary meetings have yet to be widely implemented in managing pelvic floor patients.The study aims to describe our experience and assess the utility of multidisciplinary meetings in reevaluating radiological findings, optimizing surgical plans, and developing individualized care plans for patients with pelvic floor disorders.Methods/Interventions: This is a descriptive study conducted at a tertiary referral academic center. Multidisciplinary care conferences were held monthly by a collaborative clinical team comprising colorectal and female pelvic medicine and reconstructive surgeons, neuro-gastroenterologists, pain management, radiologists, pelvic floor physical therapists, advanced practice providers, and patient care coordinators. The meetings aim to:1. Comprehensively review radiological findings in the context of patient history and physical exam.2. Develop individualized care plans, including lifestyle modification, non-surgical treatments, and pelvic floor physical therapists.3. Optimize surgical plans including using mesh, and combined surgeries. The patients were identified from the pelvic floor multidisciplinary database. All cases from August 2021 to May 2023 were included. The meetings were CME accredited.Results/Outcomes: Nineteen multidisciplinary meetings were conducted between August 2021 and May 2023 that discussed 101 cases. The patients were categorized into prolapse (n=41), functional disorders (n=38), and miscellaneous (n=22) groups. The prolapse group was classified into combined rectal and pelvic organ prolapse (n=22), and isolated rectal prolapse (n=19). After each case discussion, a comprehensive review note was created and incorporated into the patient's chart, facilitating the initiation of follow-up plans and the coordination of services.The radiology reports were amended in 18 cases (18%), with the majority of revisions related to rectal prolapse (n=15, 83%). Further assessment and workup were recommended in 17 cases (17%): prolapse (n=5), miscellaneous (n=9), and motility (n=3).Conclusion/

Discussion: Our observation underscores the significance of multidisciplinary meetings, especially in the context of complex pelvic health conditions. It further shows value in correlating the clinical assessment with radiological findings to create a treatment plan. The collective expertise of providers working together enhances the accuracy of assessments, diagnosis, and tailored care for complex patients with pelvic floor disorders. The study's limitations include the lack of standardized criteria for submitting cases to the meeting, as well as the evaluation of patients' outcomes.Categories of the discussed pelvic floor disorder cases