OBJECTIVE: To estimate the lifetime risk of stress urinary incontinence (SUI) surgery, pelvic organ prolapse (POP) surgery, or both using current, population-based surgical rates from 2007 to 2011.
METHODS: We used a 2007–2011 U.S. claims and encounters database. We included women aged 18–89 years and estimated age-specific incidence rates and cumulative incidence (lifetime risk) of SUI surgery, POP surgery, and either incontinence or prolapse surgery with 95% confidence intervals (CIs). We estimated lifetime risk until the age of 80 years to be consistent with prior studies.
RESULTS: From 2007 to 2011, we evaluated 10,177,480 adult women who were followed for 24,979,447 person-years. Among these women, we identified 65,397 incident, or first, SUI and 57,755 incident prolapse surgeries. Overall, we found that the lifetime risk of any primary surgery for SUI or POP was 20.0% (95% CI 19.9–20.2) by the age of 80 years. Separately, the cumulative risk for SUI surgery was 13.6% (95% CI 13.5–13.7) and that for POP surgery was 12.6% (95% CI 12.4–2.7). For age-specific annual risk, SUI demonstrated a bimodal peak at age 46 years and then again at age 70–71 years with annual risks of 3.8 and 3.9 per 1,000 women, respectively. For POP, the risk increased progressively until ages 71 and 73 years when the annual risk was 4.3 per 1,000 women.
CONCLUSION: Based on a U.S. claims and encounters database, the estimated lifetime risk of surgery for either SUI or POP in women is 20.0% by the age of 80 years.
LEVEL OF EVIDENCE: III
Based on a U.S. claims and encounters database, the estimated lifetime risk of surgery for stress urinary incontinence or pelvic organ prolapse is 20.0%.
Department of Obstetrics and Gynecology, the Center for Women's Health Research, and the Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Corresponding author: Jennifer M. Wu, MD, MPH, University of North Carolina at Chapel Hill, CB #7570, 3032 Old Clinics Building, Chapel Hill, NC 27599-7570; e-mail: Jennifer_wu@med.unc.edu.
Dr. Wu is supported by K23HD068404, Eunice Kennedy Shriver National Institute of Child Health & Human Development. Dr. Jonsson Funk is supported by grant number K02HS017950 from the Agency for Healthcare Research and Quality.
Presented at the 34th Annual Meeting of the American Urogynecologic Society, October 16–19, 2013, Las Vegas, Nevada.
The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality.
Financial Disclosure Catherine A. Matthews has received grant funding from Pelvalon and has been a consultant to American Medical Systems. The other authors did not report any potential conflicts of interest.