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

Locations

A

NorthShore Medical Group - Skokie

Urogynecology
9650 Gross Point Rd.
Suite 3900
Skokie, IL 60076
224.251.2374 847.933.3531 fax Get Directions 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 Get Directions 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 Get Directions This location is wheelchair accessible.
D

NorthShore Medical Group

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

Insurance

For behavioral health services, please confirm participation with your insurance company or provider.

2017 Exchange Plans (Individuals)

 
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Ambetter Insured By Celtic
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Blue Basic PPO A Multi-State Plan
PRIMARY CARE
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HOSPITALS
 
 
 
Blue Cross Blue Shield Blue Choice Preferred PPO (All Plans)
PRIMARY CARE
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HOSPITALS
 
 
 
Blue Cross Blue Shield Blue FocusCare HMO
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Blue Precision HMO (All Plans)
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Blue Cross Blue Shield Blue Premier PPO A Multi-State Plan
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Blue Solution PPO A Multi-State Plan
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield BlueCare Direct with Advocate HMO
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Cigna Connect HMO
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SPECIALTY CARE
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Cigna Connect HSA
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Off Exchange Plans (Individuals)

 
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Aetna Bronze Deductible Only HSA Eligible Savings Plus OAMC PD
Not Available In 2017
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Aetna Leap Everday Value Plan
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Aetna Leap Everyday Carelink Centegra Health System
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Aetna Savings Plus OAMC PD (All Metal Tiers)
Not Available In 2017
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SPECIALTY CARE
HOSPITALS
Aetna Whole Health Chicago (All Metal Tiers)
Not available for 2017
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Aetna Whole Health Chicago Bronze Deductible Only HSA Eligible
Not available for 2017
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Ambetter Insured By Celtic
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Blue Cross Blue Shield Blue Choice Preferred PPO (All Plans)
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Blue Cross Blue Shield Blue Choice Preferred Security PPO 100
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Blue Cross Blue Shield Blue Cross Blue Premier 101 Multi-State Plan
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Blue Cross Blue Shield Blue Cross Blue Shield Basic 103 Multi-State Plan
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Blue Cross Blue Shield Blue Precision HMO (all plans)
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Blue Cross Blue Shield Blue Precision Platinum HMO 104
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Blue Cross Blue Shield BlueCare Direct with Advocate
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Blue Cross Blue Shield Solution 102 Multi-State Plan
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Coventry $15 Copay: Silver & Gold
Not Available In 2017
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Coventry Bronze $10 Copay Carelink St. John's
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Coventry Bronze $15 Copay Carelink St. John's
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Coventry Bronze $20 Copay
Not Available In 2017
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Coventry Bronze Deductible Only HSA Eligible
Not Available In 2017
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Harken Health - an Affiliate of United Healthcare
PRIMARY CARE
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Health Alliance HMO (All Metal Tiers)
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Health Alliance POS (All Metal Tiers)
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Health Alliance PPO (All Metal Tiers)
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Humana Chicago HMOx (All Metal Tiers)
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Humana Illinois HMOx
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United Health One Golden Rule
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United Healthcare Compass (All Plans)
Not Available In 2017
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Employer Sponsored Plans

 
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Aetna Choice POS II
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Aetna Managed Choice
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Aetna Network Options
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Aetna Open Access Aetna Select
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Aetna Open Access Managed Choice
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Aetna Open Choice PPO
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Aetna Savings Plus
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Aetna Select
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Aetna Sub- Cofinity
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Aetna Sub- First Health
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Aetna Traditional Choice-Indemnity Plan
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Aetna Whole Health Chicago (All Metal Tiers)
For employers with 2-50 employees
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Beechstreet PPO Network
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Blue Cross Blue Shield Blue Advantage HMO
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Blue Cross Blue Shield Blue Choice Options
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Blue Cross Blue Shield Blue Choice Preferred PPO (All Plans)
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Blue Cross Blue Shield Blue Choice Select PPO
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Blue Cross Blue Shield Blue Choice Select Value Choice
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Blue Cross Blue Shield Blue Distinction Total Care Benefit Differentail
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Blue Cross Blue Shield Blue Options (All Metal Tiers)
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Blue Cross Blue Shield Blue PPO (All Metal Tiers)
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Blue Cross Blue Shield Blue Precision HMO Plans (All Metal Tiers)
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Blue Cross Blue Shield BlueCare Direct (All Metal Tiers)
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Blue Cross Blue Shield BlueEdge HSA and BlueEdge HCA
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Blue Cross Blue Shield BluePrint
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Blue Cross Blue Shield Community Participating Option
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Blue Cross Blue Shield HMOI
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Blue Cross Blue Shield PPO
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Blue Cross Blue Shield PPO Value Choice
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Cigna Exclusive Provider Organization EPO
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Cigna Great West Healthcare (GWH) Cigna Network
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Cigna HMO
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Cigna HMO Open Access
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Cigna HMO POS
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Cigna Medical PPO
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Cigna Medical Indemnity
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Cigna Medical LocalPlus
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Cigna Medical LocalPlus In-Network
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Cigna Medical Network
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Cigna Medical Open Access Plus (OAP)
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Cigna Medical Open Access Plus (OAP) In-Network
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Cigna Medical Open Access POS
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Cofinity PPO (an Aetna Company)
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Coventry Consumer Choices (C3)
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Coventry HMO
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Coventry POS
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Coventry PPO
PRIMARY CARE
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Galaxy Health Network
PRIMARY CARE
SPECIALTY CARE
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Harken Health
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Health Alliance HMO, PPO, POS, POS-C
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Health Link HMO
If Unicare Affiliate logo present on card
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Health Link PPO
If Unicare Affiliate logo present on card
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Health Link-Open Access I, II, III
If Unicare Affiliate logo present on card
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Healthcare's Finest Network- FHN 10 & 20
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HOSPITALS
Healthcare's Finest Network- FHN Platinum
PRIMARY CARE
SPECIALTY CARE
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Healthcare's Finest Network- HFN Community Health Connect
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Healthcare's Finest Network- HFN Community Health Connect Elite
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Healthcare's Finest Network- HFN Community Health Connect Premiere
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Healthcare's Finest Network- HFN-ID
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Humana Advocate Centered EPO
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Humana Advocate Centered HMO
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Humana Choice POS
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Humana Classic Plan (Traditional Indemnity Plan)
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Humana Coinsurance: NPOS
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Humana Coinsurance: PPO
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Humana Coinsurance:HMO
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Humana Condell Custom PPO
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Humana Copay: HMO
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Humana Copay: NPOS
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Humana Copay: PPO
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Humana COT National POS-Open Access
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Humana Edward- Elmhurst Value HMO
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Humana Edward-Elmhurst Advantage HSA/Choice PPO
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Humana High-deductible plans (HDHP) HMO
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Humana High-deductible plans (HDHP) National point of service (NPOS)
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Humana High-deductible plans (HDHP) PPO
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Humana Illinois Coordinated Care
Available In 2017
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Humana Level Funded Premium
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Humana NorthShore Complete Care
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Humana Self Funding: Administrative Services Only (ASO)
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Humana Self-Funding: Level Funded Premium (LFP)
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Humana Self-Funding: Minimum Premium (MP)
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Humana Self-Funding: Stop Loss Insurance
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Humana Simplicity (HMO, POS, PPO)
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Humana Total Health (100 or more employees)
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Multiplan/ PHCS- Health EOS Network
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Multiplan/ PHCS- MultiPlan Complementary
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Multiplan/ PHCS- MultiPlan Limited Benefit Plan
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HOSPITALS
Multiplan/ PHCS- MultiPlan Practitioner Only
PRIMARY CARE
SPECIALTY CARE
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Multiplan/ PHCS- MultiPlan Shared Savings
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Multiplan/ PHCS- PHCS Healthy Directions
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Multiplan/ PHCS- PHCS Practitioner Only
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Multiplan/ PHCS- PHCS Savility
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Multiplan/ PHCS- ValuePoint by MultiPlan
PRIMARY CARE
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NorthShore Employee Network
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Preferred Network Access
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Preferred Plan- HealthSmart Get Better
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Preferred Plan PPO
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Stratose- National Preferred Provider Network
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Three Rivers Provider PPO Network (TRPN)
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UniCare HMO
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UniCare HMO Performance Select
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Unicare PPO
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UniCare Travel Access
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United Health One Golden Rule
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United Healthcare Catalyst
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United Healthcare Charter
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United Healthcare Choice
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United Healthcare Choice Plus
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United Healthcare Core
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United Healthcare Heritage
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United Healthcare Multi-Choice
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United Healthcare Navigate and Navigate Plus
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United Healthcare Options Non-Differential PPO
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United Healthcare Options PPO
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United Healthcare Tiered Benefits
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Medicaid

 
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Aetna Better Health FHP
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Aetna Better Health ICP
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Blue Cross Blue Shield Community FHP
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Blue Cross Blue Shield Community ICP
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Cigna HealthSpring ICP
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Community Care Alliance- ICP
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Family Health Network- FHP
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Harmony/WellCare FHP Plan
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Humana ICP
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Illinicare Family Health Plan (FHP/ACA)
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Illinicare ICP
Primary Care- Current Patients Only
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Illinois Department of Public Aid (IDPA)
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Meridian FHP/ACA Expansion
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Meridian ICP
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Molina ICP
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Next Level ACA/FHP
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Medicare Advantage Plans

 
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Aetna Medicare (SM) Plan (HMO)
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Aetna Medicare (SM) Plan (PPO)
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Aetna Medicare Advantage Group Plans
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Aetna Medicare Connect Plus (PPO)/PPO Connect Plus
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Aetna Medicare Standard Plan (PPO)/PPO Standard Plan
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Aetna Medicare Value Plan (HMO)/HMO Value
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Aetna Medicare Value Plan (PPO)/PPO Value Plan
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Aetna Traditional Choice Plan
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Blue Cross Blue Shield Medicare Advantage Basic HMO
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Blue Cross Blue Shield Medicare Advantage Basic Plus HMO-POS
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Blue Cross Blue Shield Medicare Advantage Choice Plus PPO
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Blue Cross Blue Shield Medicare Advantage Choice Premier PPO
PRIMARY CARE
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Blue Cross Blue Shield Medicare Advantage Premier Plus HMO-POS
PRIMARY CARE
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Cigna-HealthSpring Advantage HMO
PRIMARY CARE
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Cigna-HealthSpring Premier HMO-POS
PRIMARY CARE
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Cigna-HealthSpring Primary HMO
PRIMARY CARE
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Cigna-HealthSpring TotalCare HMO-SNP
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Community Care Alliance Complete HMO-D-SNP
PRIMARY CARE
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Community Care Alliance HMO
PRIMARY CARE
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Harmony/WellCare Access (HMO-SNP)
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Harmony/WellCare Choice (HMO-POS)
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Harmony/WellCare Health Plan
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Harmony/WellCare RX (HMO)
PRIMARY CARE
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Harmony/WellCare Value (HMO-POS)
PRIMARY CARE
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Harmony/WellCare-Medicare HMO Plans
PRIMARY CARE
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Harmony/WellCare-Medicare Special Needs Plans
PRIMARY CARE
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Humana Choice PPO
PRIMARY CARE
SPECIALTY CARE
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Humana Community HMO Diabetes and Heart (SNP Program)
PRIMARY CARE
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HOSPITALS
Humana Gold Plus HMO
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Humana Gold Plus PFFS
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Meridian Medicare Advantage
PRIMARY CARE
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HOSPITALS
 
 
 
Molina Medicare Advantage
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
United Healthcare - AARP Medicare Complete
PRIMARY CARE
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United Healthcare AARP Medicare Complete Access
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
United Healthcare- AARP Medicare Complete Plus (HMO-POS)
PRIMARY CARE
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United Healthcare Medicare Advantage Focus
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United Healthcare- Medicare Solutions/Medicare Advantage
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Medicare Medicaid Alignment Initiative (MMAI) Plans

 
PRIMARY CARE
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Aetna Better Health MMAI
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Community MLTSS/LTSS
PRIMARY CARE
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Blue Cross Blue Shield Community MMAI
PRIMARY CARE
SPECIALTY CARE
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Cigna-HealthSpring MMAI
PRIMARY CARE
SPECIALTY CARE
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Humana MMAI
PRIMARY CARE
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Illinicare MLTSS/LTSS
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Illinicare MMAI
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Meridian MMAI
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Molina MMAI
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 

Medicare Supplemental Plans

 
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Medicare Supplemental Plans
These plans are secondary to Traditional Medicare; we accept all supplemental plans. Please confirm your coverage benefits with your supplemental carrier.
PRIMARY CARE
SPECIALTY CARE
HOSPITALS

Coverage For Active Military

 
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
TRICARE For Life
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
TRICARE Prime
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
TRICARE Prime Overseas
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
TRICARE Prime Remote
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
TRICARE Prime Remote Overseas
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
TRICARE Reserve Select
PRIMARY CARE
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Publications

  • Does physician specialty affect persistence to pharmacotherapy among patients with overactive bladder syndrome?

    International urogynecology journal 2016 Aug 18

    Authors: Tran AM, Sand PK, Seitz MJ, Gafni-Kane A, Zhou Y, Botros SM
    Abstract
    We compared persistence on overactive bladder (OAB) pharmacotherapy in patients treated in the Female Pelvic Medicine and Reconstructive Surgery (FPMRS) department compared with patients treated in the Internal Medicine (IM) and General Urology (GU) departments within an integrated health-care system. We hypothesized that persistence would be higher among FPMRS patients.
    This was a retrospective cohort study. Patients with at least one prescription for OAB between January 2003 and July 2014 were identified. Demographic, prescription and treatment specialty data and data on the use of third-line therapies were collected. The primary outcome was persistence, defined as days on continuous pharmacotherapy. Discontinuation was defined as a treatment gap of ≥45 days. Discontinuation-free probabilities were calculated using the Kaplan-Meier method and compared among the specialties. Predictors of persistence were estimated using logistic regression with adjustment for covariates. Pearson correlation coefficients were calculated to identify risk associations.
    A total of 252 subjects were identified. At 12 weeks, 6 months and 1 year, FPMRS patients had the highest persistence rates of 93 %, 87 % and 79 % in contrast to 72 %, 68 % and 50 % in GU patients, and 83 %, 71 % and 63 % in IM patients (p = 0.006, p = 0.007, p = 0.001, respectively). The median persistence in FPMRS patients was 738 days, in GU patients 313 days and in IM patients 486 days (p = 0.006). Of the FPMRS patients, 61 % switched to at least a second medication, as compared to 27 % of IM patients and 14 % of GU patients (p < 0.0001).
    Persistence on OAB pharmacotherapy was higher among FPMRS patients than among GU and IM patients in this community setting. These results suggest that persistence is higher under subspecialist supervision.
    PMID: 27539566 [PubMed - as supplied by publisher]
  • Predictive modeling and threshold scores for care seeking among women with urinary incontinence: The short forms of the Pelvic Floor Distress Inventory and Urogenital Distress Inventory.

    Neurourology and urodynamics 2016 Nov

    Authors: Gafni-Kane A, Zhou Y, Botros SM
    Abstract
    To further the interpretability of the Pelvic Floor Distress Inventory (PFDI-20) and Urogenital Distress Inventory (UDI-6) by (i) evaluating the ability of these measures to distinguish between women with urinary incontinence who do and do not seek care, (ii) defining PFDI-20 and UDI-6 threshold scores above which women with urinary incontinence seek care, and (iii) developing a predictive model for incontinence care seeking.
    An observational study was conducted with two groups of women with urinary incontinence: 256 who had not sought care and 90 seeking initial care at a tertiary center. Sample sizes were based upon the prevalence of care seeking for urinary incontinence and the number of potential predictors for care seeking. Wilcoxon rank-sum tests, receiver operating characteristics, and multivariable logistic regression were use to achieve the study aims.
    Women with urinary incontinence who sought care had higher median PFDI-20 and UDI-6 scores compared to non-care seekers (73.96 vs. 16.67, P < 0.0001, and 41.67 vs. 8.33, P < 0.0001). A PFDI-20 score of 33.33 (83.33% sensitivity and 79.30% specificity) had very good discriminatory accuracy in distinguishing care and non-care seekers (AUC 0.886 ± 0.019 [95%CI 0.8518, 0.9254] P < 0.0001). A UDI-6 score of 25.00 (83.33% sensitivity and 83.59% specificity) had excellent discriminatory accuracy in distinguishing care and non-care seekers (AUC 0.9025 ± 0.0190 [95%CI 0.8653, 0.9398] P < 0.0001). A multivariable predictive model accurately identified 82.4% of care and non-care seekers.
    A PFDI-20 score of 33.33 and UDI-6 score of 25.00 provide meaningful benchmarks for care seeking among women with urinary incontinence. Neurourol. Urodynam. 35:949-954, 2016. © 2015 Wiley Periodicals, Inc.
    PMID: 26207922 [PubMed - as supplied by publisher]
  • 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, Gafni-Kane A, Jirschele K, Silver R, Maurer D, Solomonides T, Simmons A, Silverstein J
    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, Sand PK
    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, Botros SM, Du H, Sand RI, Sand PK
    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, Goldberg RP, Sand PK, Botros SM
    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, Letko J, Jirschele K, Gafni-Kane A, Nguyen A, Du H, Goldberg RP
    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, Gafni-Kane A, Botros S, Tincello DG
    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, Sand PK
    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, Goldberg RP, Spitz JS, Sand PK
    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]