Racial and socioeconomic disparities exist in sacrocolpopexy complications and costs, investigators reported at the International Continence Society’s 2022 annual meeting.
Among 4440 women (median age 62 years) who underwent open, laparoscopic, or robotic sacrocolpopexy for apical prolapse, 18.7% experienced complications, according to 2016-2017 data from the National Inpatient Sample. Mesh revision or removal was the top complication. White patients had the highest rate (9.5%), whereas Hispanic patients had the lowest rate (7.1%). Other, minor mesh-specific complications occurred in less 1% of all groups. Anemia and infections affected similar proportions of each racial and ethnic group.
A laparoscopic vs open approach was significantly associated with 3.8-fold increased odds of complications, Matthew Mason, a medical student at the University of Miami Miller School of Medicine in Florida reported on behalf of his team. Each 1 point increment in the Charlson Comorbidity Index was significantly associated with 1.4-fold increased odds of complications.
Concurrent hysterectomy was significantly associated with 28% lower odds of complications, Mason reported. Hispanic ethnicity was significantly associated with 24% lower odds of complications, likely because they had low rates of mesh revision and removal, he noted.
“Studies with granular data on indications for revision/removal procedures are needed to confirm our findings and explore potential mechanisms underlying these variations,” Mason concluded.
The median charge for sacrocolpopexy was $51,768 for Hispanic patients, $44,522 for other races, $43,471 for White patients, and $40,634 for Black patients.
Mason M, Nackeeran S, Martin L, Wallace S, Amin K, Syan R. Racial and socioeconomic disparities in cost and post-operative complications following sacrocolpopexy in a national inpatient database. Presented at ICS 2022; September 7-10. Abstract 75.