Stress urinary incontinence surgery in the United States.
OBJECTIVE
To describe the prevalence, regional rates and demographic characteristics, morbidity, and mortality of stress urinary incontinence surgeries in the United States.


METHODS
We used data from the 1998 National Hospital Discharge Survey and the 1998 National Census to calculate rates of surgeries for stress urinary incontinence by age, race, and region of the United States. From these data we estimated morbidity and mortality associated with incontinence surgery.


RESULTS
In 1998, approximately 135000 women had inpatient surgery for stress urinary incontinence in the United States. The mean age of these women was 54.0 (+/-13.3) years. The South had the highest rate of surgery (14.8 per 10000 women), whereas the Northeast had the lowest (9.8 per 10000). In the 79% of discharges for which race was stated, the surgery rate for whites (11.6 per 10000) was almost five times greater than for blacks (2.6 per 10000), whereas the perioperative complication rate for blacks was twice that for whites (20.6% compared with 9.7%). Almost 70% of incontinence surgeries were done in combination with other major gynecologic procedures. For all incontinence surgeries, approximately 18% had complications, and mortality was rare (0.01%).


CONCLUSIONS
Stress urinary incontinence surgery is common, especially among white women. Differences in regional and racial surgical rates may represent differences in physician practice, patient expectations, and access to or utilization of care.
Waetjen
L Elaine
LE
Department of Obstetrics and Gynecology, University of California, Davis, Sacramento, California 95817, USA. lewaetjen@ucdavis.edu
Subak
Leslee L
LL
Shen
Hui
H
Lin
Feng
F
Wang
Tsung-Hsi
TH
Vittinghoff
Eric
E
Brown
Jeanette S
JS
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D003710:Demography; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge / Q000706:statistics & numerical data; D011183:Postoperative Complications; D014481:United States / Q000453:epidemiology; D014550:Urinary Incontinence, Stress / Q000453:epidemiology* / Q000208:ethnology / Q000401:mortality / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000706:statistics & numerical data*; D044465:White People / Q000706:statistics & numerical data