Age-related trends in female stress urinary incontinence surgery in Australia - Medicare data for 1994-2009.
BACKGROUND
Urinary incontinence has a high burden of suffering in Australia. There has been a significant shift towards less invasive surgery for stress urinary incontinence (SUI) over the last 15 years. Elderly women are underrepresented in surgical treatment of SUI.


OBJECTIVE
To identify patterns in the surgical treatment of women with SUI in Australia from January 1994 to December 2009.


METHODS
Gender- and age-specific data from Medicare Australia between January 1994 and December 2009 were extracted. Surgical procedures were identified using Medicare Benefit Schedules codes. Pattern of SUI surgery was analysed during the 15-year period.


RESULTS
Using data from Medicare Australia, we reported trends in female SUI surgery across Australia from 1994 to 2009. The overall number of female SUI operations has increased, almost doubling over a 3-year period following the introduction of the midurethral sling (MUS). The per capita rate increase in all SUI surgery is most prominent in women over the age of 55 years increasing 87%, compared with only 1% in younger women over the 15-year period. MUS have overtaken Burch Colposuspension as the most popular operation for female SUI across all age groups, accounting for 85.5% of all procedures performed in 2009 with 14 MUS for every one colposuspension.


CONCLUSIONS
Stress incontinence procedures performed in Australia have almost doubled with the introduction of the MUS with the greatest increase in women aged over 55 years. MUS has overtaken the Burch Colposuspension as the most popular operation for stress urinary incontinence for women in Australia.
Department of Urogynaecology, Mercy Hospital for Women, University of Melbourne, Heidelberg, Victoria, Australia.
Joseph
J
Lee
Peter L
PL
Dwyer
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D002986:Clinical Trials as Topic; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods* / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D009313:National Health Programs / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D053825:Suburethral Slings; D014550:Urinary Incontinence, Stress / Q000453:epidemiology* / Q000601:surgery*