Racial and ethnic disparity in national practice patterns for stress urinary incontinence surgery

• Published in: International Urogynecology Journal 2024, Vol.35 (1), p.35-42
• Main Authors: Margulies, Samantha L., Sakai, Nozomi, Geller, Elizabeth J.
• Format: Article
• Language: English
• Subjects: Cultural differences; Ethnicity; Gynecology; Hispanic people; Humans; Medicine; Medicine & Public Health; Original Article; Race; Retrospective Studies; Suburethral Slings; Surgery; Urinary Bladder; Urinary incontinence; Urinary Incontinence, Stress - surgery; Urologic Surgical Procedures - methods; Urology
• ISSN: 0937-3462; 1433-3023
• DOI: 10.1007/s00192-023-05583-5

Introduction and hypothesis There is a paucity of information assessing whether race/ethnicity is associated with differences in surgical treatment of stress urinary incontinence (SUI). The primary objective was to assess for racial/ethnic disparities in SUI surgeries. Secondary objectives were to assess for surgical complication differences and trends over time. Methods Using the American College of Surgeons National Surgical Quality Improvement Program database, we conducted a retrospective cohort analysis of patients undergoing SUI surgery from 2010 to 2019. Chi-squared or Fisher’s exact test and ANOVA were used for categorical and continuous variables respectively. Breslow day score and multinomial and multiple logistic regression models were used. Results A total of 53,333 patients were analyzed. Using White race/ethnicity and sling surgery as references, Hispanic patients underwent more laparoscopic surgeries (OR1.17 [CI 1.03, 1.33]) and anterior vesico-urethropexy/urethropexies (OR 1.97 [CI 1.66, 2.34]); Black patients underwent more anterior vesico-urethropexy/urethropexies (OR 1.49 [CI 1.07, 2.07]), abdomino-vaginal vesical neck suspensions (OR 2.19 [CI 1.05–4.55]), and inflatable urethral slings (OR 4.28 [CI 1.23–14.90]). White patients had lower rates of inpatient stay ( p