AMBULATORY PROCEDURES FOR URINARY INCONTINENCE IN THE UNITED STATES, 1979-1997

S. H. Boyles, MD, MPH, A. M. Weber, MD, MS, L. Meyn, MS


   Objective: The objective of our study was to describe the national rates of ambulatory surgery for urinary incontinence in women.

   Materials and Methods: We used the National Survey of Ambulatory Surgery, a federal database that samples outpatient surgery in the United States. Data from 1994 to 1996 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: The estimated number of women undergoing outpatient surgery for urinary incontinence increased from 7,200 in 1994 to 32,400 in 1996 (P<0.001) while the age-adjusted rate remained stable at 10 procedures per 100,000 women per year. The procedures performed included "other repair of the bladder" (ICD-9-CM code 57.89), "other repair of urinary stress incontinence" (code 59.7), plication of the urethrovesical junction, suprapubic sling operation, retropubic urethral suspension, paraurethral suspension, and levator muscle operation. The mean age of women undergoing these procedures was 58+14.5 years. Women undergoing incontinence procedures were 76% Caucasian, 0.3% African-American, and 24% other (including unknown). Ninety-two percent of the procedures were completed at hospitals while 8% were performed at free-standing ambulatory surgery centers. Forty percent were performed in the South, 24% in the Midwest, 16% in the West, and 15% in the Northeast.

   Conclusion: Between 1994 and 1996, the number of ambulatory surgeries for urinary incontinence in women more than quadrupled.

   Key Words: Urinary incontinence, ambulatory surgery, continence procedures.