Abstract | INTRODUCTION AND HYPOTHESIS: 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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Authors | Anne M Suskind, Samuel R Kaufman, Rodney L Dunn, John T Stoffel, J Quentin Clemens, Brent K Hollenbeck |
Journal | International urogynecology journal
(Int Urogynecol J)
Vol. 24
Issue 2
Pg. 207-11
(Feb 2013)
ISSN: 1433-3023 [Electronic] England |
PMID | 22669423
(Publication Type: Journal Article)
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Topics |
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Ambulatory Surgical Procedures
(statistics & numerical data, trends)
- Cross-Sectional Studies
- Databases, Factual
- Female
- Humans
- Middle Aged
- Retrospective Studies
- Suburethral Slings
- Urinary Incontinence, Stress
(surgery)
- Young Adult
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