SUFU 2021: Racial and Ethnic Disparities in Pelvic Organ Prolapse Surgery in the US: An Analysis of the ACS NSQIP Clinical Registry

( The study objective was to assess the types of pelvic organ prolapse (POP) surgery performed and their morbidities and mortality according to race and ethnicity in the U.S. using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database.

Women who had undergone POP procedures were stratified by race and ethnicity and differences in baseline comorbidities and distribution of POP repairs performed were compared. Racial and ethnic disparities concerning complications, readmissions, re-operations, and mortality rates were evaluated. From 2012-2017, 50,561 patients underwent a primary POP repair procedure. The majority were white (89.8%), followed by blacks (5.5%) and others (4.7%), Hispanics made up only 11.2%. Black and Hispanic patients were younger, had higher body mass index (BMI), and suffered from a higher number of comorbidities (eg. diabetes, chronic anemia) compared to white women. There were significant differences in the types of POP procedures performed according to race and ethnicity.

Despite no significant differences noted in overall complication rates, Black patients were more likely to suffer acute renal failure (p=0.006), organ/space surgical site infection (SSI) (0.023), and more likely to receive a blood transfusion (p<0.001). Hispanics were more likely to receive blood transfusions (p<0.001) but were less likely to develop pulmonary embolisms. The Black race was an independent predictor of re-admission within 30 days of the procedure. Neither race nor ethnicity was a significant predictor of re-operation or mortality. So although Black patients were at a higher risk for re-admission, there were no observed differences in complication, re-operation, or mortality rates according to race and ethnicity.

Presented by: Dayron Rodriguez, Ramy Goueli, Gary Lemack, Philippe Zimmern, Maude Carmel, UT Southwestern Medical Center

Written by: Diane K. Newman, DNP, CRNP, FAAN, BCB-PMD, Nurse Practioner and Co-Director, Penn Center for Continence and Pelvic Health Adjunct Professor of Urology in Surgery during the 2021 Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU) Winter Meeting.