Disparities in surgical treatments for stress, urge and mixed urinary incontinence: Evidence from the 2019 National Ambulatory Surgery Sample (NASS)
Purpose:: Treatment of urinary incontinence (UI) is influenced by severity of symptoms and knowledge of available treatments. However, the relationship between race/ethnicity, socioeconomic status and receiving treatment is poorly understood. We aim to characterize differences in surgical management...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-03-01
|
| Series: | Continence |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772973725000050 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1825199284400685056 |
|---|---|
| author | Christabel Egemba Edie Duncan Katherine Amin Alan Wein Alberto J. Caban-Martinez Raveen Syan |
| author_facet | Christabel Egemba Edie Duncan Katherine Amin Alan Wein Alberto J. Caban-Martinez Raveen Syan |
| author_sort | Christabel Egemba |
| collection | DOAJ |
| description | Purpose:: Treatment of urinary incontinence (UI) is influenced by severity of symptoms and knowledge of available treatments. However, the relationship between race/ethnicity, socioeconomic status and receiving treatment is poorly understood. We aim to characterize differences in surgical management of urinary incontinence subtypes (Stress UI (SUI), overactive bladder (OAB), Mixed UI (MUI)) and identify predictors of receiving the indicated surgical treatment for each. Methods:: Using the 2019 National Ambulatory Surgery Sample (NASS) we used weighted data to identify 44,996 adult females with OAB, 87,737 with SUI, and 22,873 with MUI. Chi-square analysis was used to compare surgical treatments for each diagnosis, with significance assessed at <0.05. Multivariable logistic regression models estimated the associations between socioeconomic factors of receiving the indicated treatment for OAB, SUI, or MUI. Results:: Approximately 2.5% of the study population received surgical treatment for SUI, OAB or MUI. Sling was the most utilized surgical treatment for both SUI and MUI, at 75.2% and 60.8 % respectively. While SNS was the most utilized surgical treatment for OAB, 75% of OAB patients did not undergo surgical treatment. When considering age, insurance status, and income, Black women were significantly less likely to receive surgical treatment for MUI, OAB and SUI (0.69 [0.59, 0.80], 0.69[0.62, 0.76], 0.71 [0.65, 0.77]) respectively. Conclusion:: Among female patients with UI, certain factors predict whether a patient will receive surgical treatment, including race, insurance status, and income level. These findings could inform further research to examine the factors contributing to the disparities seen. |
| format | Article |
| id | doaj-art-a8afc98a2d824ffda64e5dd32663564c |
| institution | Kabale University |
| issn | 2772-9737 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Continence |
| spelling | doaj-art-a8afc98a2d824ffda64e5dd32663564c2025-02-08T05:01:46ZengElsevierContinence2772-97372025-03-0113101748Disparities in surgical treatments for stress, urge and mixed urinary incontinence: Evidence from the 2019 National Ambulatory Surgery Sample (NASS)Christabel Egemba0Edie Duncan1Katherine Amin2Alan Wein3Alberto J. Caban-Martinez4Raveen Syan5MD-MPH Program, Leonard M. Miller School of Medicine, University of Miami, United States of AmericaMD-MPH Program, Leonard M. Miller School of Medicine, University of Miami, United States of AmericaDepartment of Urology, Leonard M. Miller School of Medicine, University of Miami, United States of AmericaDepartment of Urology, Leonard M. Miller School of Medicine, University of Miami, United States of AmericaDepartment of Public Health Sciences, Leonard M. Miller School of Medicine, University of Miami, United States of AmericaDepartment of Urology, Leonard M. Miller School of Medicine, University of Miami, United States of America; Correspondence to: 1150 NW 14th Street, Suite 309 Miami, FL 33136, United States of America.Purpose:: Treatment of urinary incontinence (UI) is influenced by severity of symptoms and knowledge of available treatments. However, the relationship between race/ethnicity, socioeconomic status and receiving treatment is poorly understood. We aim to characterize differences in surgical management of urinary incontinence subtypes (Stress UI (SUI), overactive bladder (OAB), Mixed UI (MUI)) and identify predictors of receiving the indicated surgical treatment for each. Methods:: Using the 2019 National Ambulatory Surgery Sample (NASS) we used weighted data to identify 44,996 adult females with OAB, 87,737 with SUI, and 22,873 with MUI. Chi-square analysis was used to compare surgical treatments for each diagnosis, with significance assessed at <0.05. Multivariable logistic regression models estimated the associations between socioeconomic factors of receiving the indicated treatment for OAB, SUI, or MUI. Results:: Approximately 2.5% of the study population received surgical treatment for SUI, OAB or MUI. Sling was the most utilized surgical treatment for both SUI and MUI, at 75.2% and 60.8 % respectively. While SNS was the most utilized surgical treatment for OAB, 75% of OAB patients did not undergo surgical treatment. When considering age, insurance status, and income, Black women were significantly less likely to receive surgical treatment for MUI, OAB and SUI (0.69 [0.59, 0.80], 0.69[0.62, 0.76], 0.71 [0.65, 0.77]) respectively. Conclusion:: Among female patients with UI, certain factors predict whether a patient will receive surgical treatment, including race, insurance status, and income level. These findings could inform further research to examine the factors contributing to the disparities seen.http://www.sciencedirect.com/science/article/pii/S2772973725000050Stress urinary incontinenceMixed urinary incontinenceOveractive bladderSurgeryUrgency urinary incontinence |
| spellingShingle | Christabel Egemba Edie Duncan Katherine Amin Alan Wein Alberto J. Caban-Martinez Raveen Syan Disparities in surgical treatments for stress, urge and mixed urinary incontinence: Evidence from the 2019 National Ambulatory Surgery Sample (NASS) Continence Stress urinary incontinence Mixed urinary incontinence Overactive bladder Surgery Urgency urinary incontinence |
| title | Disparities in surgical treatments for stress, urge and mixed urinary incontinence: Evidence from the 2019 National Ambulatory Surgery Sample (NASS) |
| title_full | Disparities in surgical treatments for stress, urge and mixed urinary incontinence: Evidence from the 2019 National Ambulatory Surgery Sample (NASS) |
| title_fullStr | Disparities in surgical treatments for stress, urge and mixed urinary incontinence: Evidence from the 2019 National Ambulatory Surgery Sample (NASS) |
| title_full_unstemmed | Disparities in surgical treatments for stress, urge and mixed urinary incontinence: Evidence from the 2019 National Ambulatory Surgery Sample (NASS) |
| title_short | Disparities in surgical treatments for stress, urge and mixed urinary incontinence: Evidence from the 2019 National Ambulatory Surgery Sample (NASS) |
| title_sort | disparities in surgical treatments for stress urge and mixed urinary incontinence evidence from the 2019 national ambulatory surgery sample nass |
| topic | Stress urinary incontinence Mixed urinary incontinence Overactive bladder Surgery Urgency urinary incontinence |
| url | http://www.sciencedirect.com/science/article/pii/S2772973725000050 |
| work_keys_str_mv | AT christabelegemba disparitiesinsurgicaltreatmentsforstressurgeandmixedurinaryincontinenceevidencefromthe2019nationalambulatorysurgerysamplenass AT edieduncan disparitiesinsurgicaltreatmentsforstressurgeandmixedurinaryincontinenceevidencefromthe2019nationalambulatorysurgerysamplenass AT katherineamin disparitiesinsurgicaltreatmentsforstressurgeandmixedurinaryincontinenceevidencefromthe2019nationalambulatorysurgerysamplenass AT alanwein disparitiesinsurgicaltreatmentsforstressurgeandmixedurinaryincontinenceevidencefromthe2019nationalambulatorysurgerysamplenass AT albertojcabanmartinez disparitiesinsurgicaltreatmentsforstressurgeandmixedurinaryincontinenceevidencefromthe2019nationalambulatorysurgerysamplenass AT raveensyan disparitiesinsurgicaltreatmentsforstressurgeandmixedurinaryincontinenceevidencefromthe2019nationalambulatorysurgerysamplenass |