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International Urogynecology Journal

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01-02-2013 | Original Article

Population-based trends in ambulatory surgery for urinary incontinence

Authors: Anne M. Suskind, Samuel R. Kaufman, Rodney L. Dunn, John T. Stoffel, J. Quentin Clemens, Brent K. Hollenbeck

Published in: International Urogynecology Journal | Issue 2/2013

Abstract

Introduction and hypothesis

Surgical procedures for stress urinary incontinence (SUI) have become progressively less invasive and easier to perform with the development of new technologies such as the midurethral sling. For these reasons, it seems logical to conclude that midurethral slings would supplant other surgical treatments for incontinence. The purpose of this study was to assess the impact of this technology on trends in ambulatory surgery for incontinence over the past decade.

Methods

We searched Current Procedure Terminology codes and the State Ambulatory Surgery Database from 2001 through 2009 to identify all ambulatory procedures for incontinence. Next, we calculated age-adjusted rates separately for each procedure. We then fit a multilevel model to characterize patient and regional factors associated with the preferential use of midurethral slings over alternative treatments.

Results

Midurethral slings and submucosal injections comprised >90 % of all ambulatory procedures for SUI during the time period examined. Age-adjusted rates of midurethral slings increased dramatically, from 2.36 to 9.45/10,000 population (p < 0.001), whereas rates of submucosal injections remained relatively stable, from 1.75 to 1.41/10,000 population (p = 0.226). Not surprisingly, older ([odds ratio (OR) 0.61; 95 % confidence interval (CI) 0.56–0.66] and more infirm patients (OR 0.60; CI 0.44–0.83) were more likely to receive submucosal injection therapy than to receive midurethral slings.

Conclusions

Rates of midurethral slings have increased significantly by fourfold. Rates of submucosal injections, however, have remained fairly stable during this time period, suggesting that sling dissemination has led to an increase in rates of incontinence procedures as opposed to replacing old technologies in the ambulatory setting.

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Title: Population-based trends in ambulatory surgery for urinary incontinence
Authors: Anne M. Suskind
Samuel R. Kaufman
Rodney L. Dunn
John T. Stoffel
J. Quentin Clemens
Brent K. Hollenbeck
Publication date: 01-02-2013
Publisher: Springer-Verlag
Published in: International Urogynecology Journal / Issue 2/2013
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-012-1823-y

At a glance: The STEP trials

Springer Medicine

Population-based trends in ambulatory surgery for urinary incontinence

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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