PROLAPSE PROCEDURES IN THE UNITED STATES, 1979-1997

S. Hamilton-Boyles, MD, A. Weber, MD, and L. Meyn, MS.

Objective: The objective of our study was to describe national rates of surgery for pelvic organ prolapse.

Materials and Methods: We used the National Hospital Discharge Survey, a federal database of a national sample of inpatient hospitals in the United States. Data from 1979 to 1997 were analyzed for diagnoses and procedures coded using the ICD-9-CM classification system. Age-adjusted rates were calculated using the 1990 census population and compared for change over time using the Score test for linear trend.

Results: Approximately 176,000 women undergo inpatient procedures for prolapse in the United States each year, ranging from 148,000 in 1988 to 205,000 in 1997. The age-adjusted rate for all prolapse procedures varied from 1.2 to 1.9 per 1,000 women per year. There was a significant decrease in the overall age-adjusted rate of procedures performed over the study period, from 1.9 to 1.5 procedures per 1,000 women (P = 0.03). The average age of women having prolapse surgery increased from 48.9 years in 1979 to 55.4 years in 1997 (P < 0.001). Most women (81%) were white, 3% were black, and 16% were coded as other races. Most women had either private (61%) or government insurance including Medicare (34%). Average length of hospital stay decreased from 8.7 days in 1979 to 2.7 days in 1997 (P < 0.001).

Conclusion: Prolapse procedures are performed very frequently in the United States, although the rate has decreased slightly over time.

Key Words: Pelvic organ prolapse, hospital discharge data, rate of prolapse surgery.