Adam Gafni-Kane, M.D.

Adam Gafni-Kane, M.D.

Adam Gafni-Kane, M.D.

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Conditions & Procedures

Conditions

Female Reproductive Health, Incontinence, Overactive Bladder, Pelvic Floor Disorders, Pelvic Pain, Pelvic Prolapse, Urinary Infections, Urogynecology

Procedures

Minimally Invasive Approach, Pelvic Reconstruction Surgery

General Information

Gender

Male

Affiliation

NorthShore Medical Group

Expertise

Urogynecology

Academic Rank

Clinical Assistant Professor

Languages

English

Board Certified

Female Pelvic Medicine and Reconstructive Surgery, Obstetrics & Gynecology

Clinical Service

Education, Training & Fellowships

Medical School

Yale University School of Medicine, 2005

Internship

Yale University School of Medicine, 2006

Residency

Yale-New Haven Hospital, 2009

Fellowship

University of Chicago - Northshore University Healthsystem

Locations

A

NorthShore Medical Group

9650 Gross Point Rd.
Suite 3900
Skokie, IL 60076
224.251.2374 847.933.3531 fax This location is wheelchair accessible.
B

NorthShore Medical Group

225 N. Milwaukee Ave.
Suite 1500
Vernon Hills, IL 60061
224.251.2374 847.933.3531 fax This location is wheelchair accessible.
C

NorthShore Medical Group

757 Park Ave. West
Suite 3870
Highland Park, IL 60035
224.251.2374 847.933.3531 fax This location is wheelchair accessible.
D

NorthShore Medical Group

15 Tower Ct.
Suite 300
Gurnee, IL 60031
224.251.2374 847.933.3531 fax This location is wheelchair accessible.

Insurance

Commercial Plans
  • Aetna Choice POS (Open Access) and POS II (Open Access)
  • Aetna Elect Choice EPO and EPO Open Access
  • Aetna Health Network Options
  • Aetna HMO (including Open Access)
  • Aetna Managed Choice (Open Access)
  • Aetna Managed Choice POS
  • Aetna Open Access Aetna Select (Aetna HealthFund)
  • Aetna Open Access Elect Choice EPO (Aetna HealthFund)
  • Aetna Open Access Managed Choice POS (Aetna HealthFund)
  • Aetna Open Choice PPO
  • Aetna Open Choice PPO (Aetna HealthFund)
  • Aetna Premier Care Network
  • Aetna QPOS
  • Aetna Select
  • Aetna Select (Open Access)
  • Beechstreet PPO Network
  • Blue Cross Blue Shield - PPO Products
    Not Contracted Blue Cross Blue Shield Blue Choice PPO
  • Blue Cross Blue Shield Blue Advantage
    Verify PCP Participation
  • Blue Cross Blue Shield HMOI
  • Cigna HMO
  • Cigna LocalPlus
  • Cigna Open Access Plus (OAP)
  • Cigna Open Access Plus with CareLink (OAPC)
  • Cigna POS
  • Cigna PPO
  • Cofinity PPO (an Aetna Company)
  • Coventry Health Care Elect Choice EPO
  • Coventry Health Care First Health PPO
  • Galaxy Health PPO Network
  • Great West PPO/POS
  • Healthcare's Finest Network (HFN)
  • Humana - All Commercial Plans (including Choice Care)
  • Humana - NorthShore Complete Care
  • Humana/ChoiceCare Network PPO
  • Medicare
  • Multiplan and PHCS PPO Network (Including PHCS Savility)
  • NorthShore Employee Network I (EPO)
  • NorthShore Employee Network II (EPO Plus & CDHP)
  • Preferred Plan PPO
  • Three Rivers Provider PPO Network (TRPN)
  • Tricare
  • Unicare
  • United Healthcare - All Commercial Plans
    Not Contracted United Healthcare Core
    Not Contracted United Healthcare Navigate
Exchange Plans
  • Not Contracted Aetna
  • Blue Cross Blue Shield - PPO Products
    Not Contracted Blue Cross Blue Shield Blue Choice PPO
  • Blue Cross Blue Shield Blue Precision
    Verify PCP Participation
  • Not Contracted Coventry
  • Humana National
  • Land of Lincoln - All Products
  • Not Contracted United Healthcare Compass
Medicaid
  • Illinois Department of Public Aid (IDPA)
  • Illinicare ICP
  • Community Care Partners
Medicare Advantage Plans
  • Aetna Medicare (SM) Plan (HMO/Open Access HMO)
  • Aetna Medicare (SM) Plan (PPO)
  • Blue Cross Blue Shield Medicare Advantage PPO Plan
    Effective 1/1/2015
  • Cigna-HealthSpring Advantage HMO
  • Cigna-HealthSpring Premier HMO-POS
  • Cigna-HealthSpring Primary HMO
  • Humana Gold Plus HMO
  • Humana Gold Plus PFFS
  • HumanaChoice PPO
  • United Healthcare - All Medicare Plans
Medicare Medicaid Alignment Initiative (MMAI) Plans
  • Blue Cross Blue Shield Community
  • HealthSpring
  • Humana
  • Illinicare Health Plan
  • Meridian Complete

Publications

  • An automatic female pelvic medicine and reconstructive surgery registry and complications manager developed in an electronic medical record.

    Female pelvic medicine & reconstructive surgery

    Authors: Goldberg RP,
    Abstract
    The aim of this study is to incorporate a structured clinical documentation system (SCDS) into the electronic medical record (EMR), allowing for automatic flow of clinical data into an enterprise data warehouse (EDW) and clinical registry.
    The SCDS programming was developed within inpatient and ambulatory EMR domains, allowing routine documentation in these settings to trigger data flow into an EDW. An extensive set of clinical outcomes was included, focusing on data points likely to exist in the forthcoming American Urogynecologic Society Pelvic Floor Disorders Registry. An electronic complications manager was developed to link immediate and/or delayed complications to the index surgery, allowing for accurate morbidity tracking.
    All aspects of EMR documentation were successfully reconfigured for charting in both inpatient and office settings. Clinicians transitioned to clinical documentation such that no additional data entry beyond routine charting was required, and this resulted in data flow into the EDW. Physician feedback led to the refinement of SCDS entry fields.
    This SCDS system allows for automatic flow of a comprehensive data set from our EMR into an EDW and registry. It also provides the ability to systematically track complications and longitudinal clinical outcomes. Integrated systems may eliminate barriers associated with free-standing registries including those relating to cost, maintenance, data integrity, and consistent clinician participation. In addition, it should improve ascertainment of a complete patient population in comparison to voluntary registries.
    PMID: 25185625 [PubMed - as supplied by publisher]
  • Vesico-ureteral reflux in women with idiopathic high-pressure detrusor overactivity: prevalence, bladder function, and effect on the upper urinary tract.

    International urogynecology journal 2014 Oct

    Authors: Gafni-Kane A,
    Abstract
    To assess the prevalence of vesico-ureteral reflux (VUR) and upper urinary tract damage in women with idiopathic high-pressure detrusor overactivity (IHPDO) and to characterize their bladder function.
    A retrospective chart review of women diagnosed with IHPDO (detrusor pressures > 40 cm H2O during involuntary bladder contractions) from 2007 to 2010 was conducted. Women were assessed for VUR by X-ray voiding cysto-urethrogram. Renal ultrasound or CT urogram, serum BUN/creatinine, and urinalyses were performed if reflux reached the renal pelvices. Cystometric and voiding pressure study data were reviewed for detrusor overactivity pressure and volume, voiding dysfunction, urethral relaxation, compliance, and bladder outlet obstruction.
    Sixty-five women were diagnosed with IHPDO, and 50 completed an X-ray voiding cysto-urethrogram. The median (range) detrusor overactivity pressure was 65 (41-251) cm H2O. Four (8.0%) women had IHPDO; none had upper urinary tract deterioration. The majority of women exhibited urethral relaxation with voiding, impaired compliance, and bladder outlet obstruction.
    Women with IHPDO are at risk of low-grade vesico-ureteral reflux. However, most women with IHPDO are likely protected from reflux by intermittent exposure to high detrusor pressures and the ability to decompress the bladder by urethral relaxation.
    PMID: 24803214 [PubMed - as supplied by publisher]
  • Measuring the success of combined intravesical dimethyl sulfoxide and triamcinolone for treatment of bladder pain syndrome/interstitial cystitis.

    International urogynecology journal 2013 Feb

    Authors: Gafni-Kane A,
    Abstract
    The purpose of this study was to investigate change in bladder capacity as a measure of response to combined intravesical dimethyl sulfoxide (DMSO) and triamcinolone instillations for the treatment of newly diagnosed bladder pain syndrome/interstitial cystitis (BPS/IC).
    141 newly diagnosed women were identified retrospectively. 79 were treated with weekly DMSO/triamcinolone instillations. Change in bladder capacity with bladder retrofill, daytime urinary frequency, nocturia episodes per night, and Likert scale symptom scores were reviewed. Wilcoxon signed-rank tests, Wilcoxon rank-sum tests, Spearman's rank correlations, COX regression analysis, and a Kaplan-Meier survival curve were performed.
    Significant changes (median (25(th)-percentile to 75(th)-percentile) were noted for bladder capacity (75 mL (25 to 130 mL), p < 0.0001), inter-void interval (0 hrs (0 to 1 hour), p < 0.0001), nocturia episodes per night (-1 (-2 to 0), p < 0.0001), and aggregate Likert symptom scores (-2 points (-5 to 0), p < 0.0001). Percent change in bladder capacity correlated positively with percent change in inter-void interval (p = 0.03) and negatively with percent changes in nocturia (p = 0.17) and symptom scores (p = 0.01). Women without detrusor overactivity (DO) had greater percent changes in capacity than women with DO (62.5 % vs. 16.5 %, p = 0.02). 61.3 % of patients were retreated with a 36 weeks median time to retreatment and no difference in time to retreatment based upon DO. Greater capacity was protective against retreatment (hazard ratio = 0.997 [95 % CI 0.994,0.999], p = 0.02).
    Percent change in bladder capacity is a useful objective measure of response to intravesical DMSO/triamcinolone for newly diagnosed BPS/IC. Clinical outcomes do not differ based upon presence of DO.
    PMID: 22699887 [PubMed - as supplied by publisher]
  • Enhanced interpretability of the PFDI-20 with establishment of reference scores among women in the general population.

    Neurourology and urodynamics 2012 Nov

    Authors: Gafni-Kane A,
    Abstract
    To enhance the interpretability of the PFDI-20 by establishing a score distribution for women in the general population and to determine whether scores correspond with urinary and anal incontinence (UI and AI).
    Subjects recruited during Twins Day Festivals from 2004 to 2009 completed a survey assessing for stress and urgency urinary incontinence (SUI and UUI) and AI of flatus and stool. Score distributions for the PFDI-20 and each of its subscales were determined for all subjects and for women with isolated forms of incontinence. Scores were compared between continent and incontinent women and between incontinent subtypes by Wilcoxon rank-sum tests.
    One thousand three hundred seventy-six women completed the survey with PFDI-20 (Median = 8.9, IQR 31.3), POPDI-6 (Median = 0, IQR = 8.3), CRADI-8 (Median = 0, IQR = 10.7), and UDI-6 (Median = 0, IQR = 16.7). PFDI-20, POPDI-6, CRADI-8, and UDI-6 scores were significantly greater among women reporting isolated SUI (P < 0.0001, P = 0.04, P < 0.0001, P < 0.0001, respectively), UUI (P < 0.0001, P = 0.02, P < 0.0001, P < 0.0001, respectively), mixed UI (P < 0.0001 each), AI flatus (P < 0.0001 each), and AI stool (P < 0.0001 each) compared to those denying incontinence. Women with mixed UI had significantly greater PFDI-20 and UDI-6 scores compare to those with SUI (P < 0.0001) or UUI (P < 0.0001). Subjects with AI stool had significantly greater PFDI-20 and CRADI-8 scores compared to those with AI flatus (P = 0.01).
    PFDI-20 scores from a sample of the general population correspond with the presence or absence of UI and AI. These normative and symptom-specific score distributions for the PFDI-20 provide reference points to gauge the effect of disease and intervention on quality of life for women with incontinence.
    PMID: 22532248 [PubMed - as supplied by publisher]
  • Minimal mesh repair for apical and anterior prolapse: initial anatomical and subjective outcomes.

    International urogynecology journal 2012 Dec

    Authors: Vu MK,
    Abstract
    Here we describe anatomic and quality of life (QOL) outcomes of an anterior and apical compartment prolapse repair involving a reduced mesh implant size and apex-only fixation.
    One hundred and fifteen patients undergoing the repair at a single urogynecology center were assessed using the Pelvic Organ Prolapse Quantification (POP-Q) and inpatient chart reviews. A horizontal incision eliminated overlap with the mesh, and each sacrospinous ligament was approached anteriorly by blunt dissection. Recurrence was defined as apical (C), or anterior (Aa or Ba) ≥0, and secondary analyses were performed using POP-Q ≥ -1 as the anatomic threshold. Pelvic Floor Distress Inventory (PFDI), Surgical Satisfaction Questionnaires (SSQ) and a dyspareunia symptom scale were analyzed pre- and postoperatively.
    Fifty-three women with uterus in situ demonstrated a combined anterior-apical recurrence rate of 1.89 %, including no anterior (Ba ≥ -1) and one apical (C ≥ -1) recurrence. Forty-seven women undergoing repair for vault prolapse had recurrence rates ranging from 0 % in those with prior hysterectomy to 4.2 % in those undergoing concurrent hysterectomy. The rate of mesh exposure was 3/115 (2.6 %), including two in women with concurrent hysterectomy. Self-reported dyspareunia was more common preoperatively (13.4 %) than postoperatively (9.3 %). PFDI scores improved in all domains, and 93 % completing the SSQ reported they were satisfied and would choose the surgery again.
    This technique resulted in successful outcomes within both anterior and apical compartments with a low rate of mesh complication, and no cases required mesh removal or hospital readmission. High rates of satisfaction and improved condition-specific QOL were observed.
    PMID: 22531956 [PubMed - as supplied by publisher]
  • Factors influencing women's participation in urogynecology research in the UK and USA.

    Neurourology and urodynamics 2011 Nov

    Authors: Bakali E,
    Abstract
    To explore factors influencing willingness to participate in urogynecology trials and explore associations between demographics, quality of life score (ICIQ-SF), and willingness to participate.
    The Bladder Clinic Questionnaire (BCQ) was developed, piloted, and validated. The BCQ and ICIQ-SF were distributed to women attending urogynecologists in tertiary referral centers in the UK and USA. The BCQ collected demographic data and data on previous involvement in research and posed eight research scenarios. Women were asked to record their willingness to participate on a Likert scale, collapsed for analysis into "any yes," "unsure," or "any no," giving a BCQ score between 0 and 16 (higher scores indicating greater willingness).
    Two hundred sixty-seven UK women and 200 US women returned completed questionnaires. Median BCQ score differed between UK and US women (11 [0-16] vs. 10 [0-16]; P = 0.004); median ICIQ score was similar (9 [0-21] vs. 9 [0-20]). ICIQ score was higher in UK women willing to participate in two scenarios: standard operation versus new operation (P = 0.007), and new operation versus new operation (P = 0.001). UK women were uniformly more willing to take part in all scenarios involving established treatments.
    We identified cultural differences in willingness to participate and differences depending on type of intervention proposed which supports the growing evidence that detailed pilot work is required during planning of intervention studies.
    PMID: 21780172 [PubMed - as supplied by publisher]
  • Foreign-body granuloma after injection of calcium hydroxylapatite for type III stress urinary incontinence.

    Obstetrics and gynecology 2011 Aug

    Authors: Gafni-Kane A,
    Abstract
    Foreign-body granuloma is a potential complication of periurethral injection of calcium hydroxylapatite for the treatment of type III stress urinary incontinence.
    We present two cases of foreign-body granuloma formation after periurethral injection of calcium hydroxylapatite for type III stress urinary incontinence. Excision of the lesion resulted in cessation of pain in a symptomatic patient; however, it led to the resumption of stress urinary incontinence in both cases.
    Foreign-body granuloma is not the normative response to periurethral bulking with calcium hydroxylapatite. However, granuloma should be considered when a periurethral mass is encountered after injection of calcium hydroxylapatite for type III stress urinary incontinence.
    PMID: 21768839 [PubMed - as supplied by publisher]
  • Extrasphincteric perianal fistulae after sacrospinous fixation for apical prolapse.

    Obstetrics and gynecology 2011 Feb

    Authors: Gafni-Kane A,
    Abstract
    Delayed extrasphincteric perianal fistulae may be encountered after sacrospinous vaginal vault suspension or hysteropexy with permanent sutures.
    We report two cases of extrasphincteric perianal fistulae: one after a sacrospinous vaginal vault suspension and one after a sacropsinous hysteropexy. Reproduction of the vaginal dissection performed to place the sacrospinous fixation sutures failed to expose the sutures, and the fistulae persisted. Perianal fistulotomy and fistulectomy, however, resulted in identification and excision of the sutures.
    Perianal fistulotomy or fistulectomy offers the most successful approach to identifying the inciting sutures.
    PMID: 21252781 [PubMed - as supplied by publisher]
  • An ileal endometrioma: of carcinoids and cadherin.

    Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract 2007 Feb

    Authors: Pannala R,
    Abstract
    A 38-year-old woman with history of prior adrenalectomy for Cushing's syndrome presented with intermittent right lower quadrant (RLQ) abdominal pain, nausea, bloating, and non-bloody diarrhea for 2 months. Symptoms were not related to her menstrual periods. Examination revealed only an ill-defined mass in the RLQ. Investigations for infectious causes, inflammatory bowel disease, and carcinoid tumor were negative. Computed tomography (CT) demonstrated a terminal ileal mass with mesenteric stranding and dilatation of the proximal bowel. At laparotomy, a fibrotic, terminal ileal mass with matted adhesions involving the mesentery and retroperitoneum was resected. Histopathological examination identified multiple foci of endometriosis extending from the serosal surface into the mucosa of the terminal ileum. Immunostaining revealed E- and P-cadherin, but not N-cadherin immuno-positivity. Mucosal involvement without cyclical menstrual symptoms and intestinal obstruction is an unusual presentation of intestinal endometriosis. Although the mechanism of endometriosis is not clear, the role of cell adhesion molecules such as cadherins has received attention. Increased expression of E- and P-cadherin and decreased N-cadherin expression in our patient demonstrates differential expression of these cadherins in endometriotic tissue. Future studies may investigate patterns of differential expression of these cadherins in a series of cases to elucidate the mechanisms of migration of endometriotic tissue.
    PMID: 17390177 [PubMed - as supplied by publisher]
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