Medline ® Abstracts for References 1,2
of 'Surgical management of stress urinary incontinence in women: Bladder neck fascial sling procedures'
Trends in stress urinary incontinence inpatient procedures in the United States, 1979-2004.
Oliphant SS, Wang L, Bunker CH, Lowder JL
Am J Obstet Gynecol. 2009 May;200(5):521.e1-6.
OBJECTIVE: The purpose of this study was to describe national trends in surgery for female stress urinary incontinence (SUI).
STUDY DESIGN: We used data from the National Hospital Discharge Survey, a federal dataset sampling patient discharges from US inpatient hospitals. We analyzed patient and hospital demographics and International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM) diagnostic and procedures codes for 1979-2004. Age-adjusted rates per 1000 women were calculated with 1990 US Census population data.
RESULTS: The number of women who have undergone SUI surgery each year increased from 48,345 in 1979 to 103,467 in 2004. In women>or = 52 years old, the age-adjusted rate more than doubled from 0.64-1.60 procedures per 1000 women; in women<52 years old, the age-adjusted rate fell from 0.57-0.47. Age-adjusted rates for retropubic urethral suspension (ICD-9-CM, 59.5) fell from 0.37 in 1979 to 0.14 in 2004. For suprapubic sling procedures (ICD-9-CM, 59.4), the age-adjusted rates rose from 0.02 in 1979to a peak of 0.10 in 1997 and then fell to 0.03 in 2004. Age-adjusted rates for other repair of urinary stress incontinence (ICD-9-CM, 59.79) rose from 0.06 in 1979 to 0.64 in 2004.
CONCLUSION: The number of women who have undergone SUI surgery increased significantly from 1979-2004. Because the National Hospital Discharge Survey data do not include ambulatory procedures, accurate information on same-day surgeries is unavailable. Currently no ICD-9-CM procedure code exists specifically for midurethral sling procedures. Both missed sampling of same-day procedures and nonspecific or inaccurate coding may explain the surprising decline in suprapubic sling procedures and the rise in rates of other repair of SUI. A national ambulatory surgical database and a specific code for midurethral sling are needed to capture these important data.
Division of Urogynecology, Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Hospital, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Trends in inpatient urinary incontinence surgery in the USA, 1998-2007.
Wu JM, Gandhi MP, Shah AD, Shah JY, Fulton RG, Weidner AC
Int Urogynecol J. 2011 Nov;22(11):1437-43. Epub 2011 Aug 17.
INTRODUCTION AND HYPOTHESIS: This study was conducted to assess national rates in stress urinary incontinence (SUI) surgery in the USA from 1998 to 2007.
METHODS: We utilized the 1998-2007 Nationwide Inpatient Sample and assessed women aged 20 years and older who underwent SUI surgery based on the International Classification of Diseases, 9th Revision (ICD-9) procedure and diagnosis codes.
RESULTS: The total number of SUI surgeries performed during this 10-year period was 759,821. The annual number of procedures increased from 37,953 in 1998 to 94,910 in 2007. The type of SUI surgery performed also changed (p<0.001). In 1998, retropubic suspensions represented 52.3%, decreasing to 13.8% in 2007. "Other repair of SUI" (ICD-9 59.79) comprised 22.4% in 1998, increasing to 75.2% in 2007, likely representing midurethral slings.
CONCLUSIONS: The total number and incidence rates of SUI surgeries have increased from 1998 to 2007. The type of SUI surgery performed has also changed significantly, likely secondary to adoption of midurethral slings.
Department of Obstetrics and Gynecology, Duke University, Durham, NC, USA. email@example.com