20% lifetime risk of pelvic floor surgery in women

Image: PD 

1. 1 in 5 women will undergo surgery for either stress urinary incontinence or pelvic organ prolapse by age 80. 

2. The incidence of either surgery increases with age in a bimodal fashion, peaking at ages 46 and 70-71. 

Evidence Rating Level: 2 (Good) 

Study Rundown: Using a national insurance database, researchers found that the incidence of pelvic prolapse or stress urinary incontinence surgery increased bimodally with age, peaking at age 46 and again at age 70 years. The lifetime incidence of either surgery was found to be 20%, nearly double the 11% incidence quoted in older studies. This may be due in part to use of a larger sample size in this study and/or an increase in the popularity of these procedures with the development of less invasive techniques and aging of the population. A limitation of this study is that researchers included only women with employer-based insurance, resulting in a study population with a higher socioeconomic class than the national average. Future studies might obtain a more nationally representative estimate of prolapsed procedures by abstracting data from both employer-based insurance and Medicaid databases.

Click to read the study in Obstetrics & Gynecology

Relevant Reading: Lifetime risk of surgical management for pelvic organ prolapse or stress urinary incontinence

Study Author, Dr. Jennifer M. Wu, MD, MPH, talks to 2 Minute Medicine: University of North Carolina, Associate Professor, Department of Obstetrics and Gynecology

“The fact that 1 in 5 women undergo a surgery for stress urinary incontinence or pelvic organ prolapse in their lifetimes underscores the high prevalence of these conditions and the degree to which they impair quality of life. With the aging population in the U.S., these conditions will become an even greater public health burden in the future. Our study highlights the need raise awareness and let women know that there are available treatment options.”

In-Depth [retrospective cohort]: Researchers used a national U.S. claims and encounters database of 10,277,480 women from 2007-2011 (24,979,447 person-years) to identify the incidence rates of stress urinary incontinence and pelvic organ prolapse surgery in women ages 18-89. Results were stratified by age. The lifetime risk (until age 80) of needing either pelvic organ prolapse or urinary incontinence surgery was calculated.

During the study period, 65,7397 women underwent surgery for stress urinary incontinence, while 57,755 had prolapse surgery. The lifetime incidence of undergoing either surgery was 20.0% (95% CI: 19.9-20.2). There was a bimodal peak in the age-specific annual incidence of stress urinary incontinence surgery at 46 years and 70 years. The risk of undergoing prolapse surgery increased progressively until ages 71 and 73 years.

More from this author: In elderly, robotic surgery for endometrial cancer linked with lower morbidity, Individualized pelvic floor muscle training improves prolapse symptoms, Knowledge gaps regarding fertility prevalent in reproductive aged women, IUD contraception equally safe in teenagers as in older women

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