Design: A waste audit was performed during 20 isolated retropubic MUS.

Setting: Our study was performed at a tertiary care center between November 2022 and April 2023. Surgeries were performed by 7 urogynecologists. Disposable and non-disposable items were pulled ahead of time in either a pre-picked surgical pack or tray. The surgical pack consisted of disposable items for vaginal minor procedures, which surgeons were not allowed to modify. Non-disposable instruments were included in a customized MUS surgical tray.

Patients or Participants: N/A

Interventions: During the waste audits, used and added items were documented. All disposable material was weighed after the completion of each procedure to calculate the amount of waste generated. The utilization rate of each item was calculated after 20 waste audits with a goal of creating a custom MUS surgical pack and updating our MUS surgical tray to include only items and instruments with >20% utilization rate.

Measurements and Main Results: 10 out of 21 non-disposable instruments had a utilization rate <20%, and no added instruments had a utilization rate >20%. A re-sterilization cost for these underutilized instruments is estimated to be $6.12 per isolated MUS. Out of 26 disposable items, 6 had a utilization rate <20%. 18 non-disposable items were added during surgery, and 15 of these had a utilization rate >20%. Mean weight of surgical waste per case was 5.65 kg (+1.10).

Conclusion: We identified several opportunities to reduce waste at the time of MUS. At a rate of 300 slings per year, a PDSA audit such as this can reduce a significant amount of disposed plastic and healthcare costs. Our study highlights a method for institutions to implement waste audits to improve sustainability.