Age- and Population-Adjusted Trends in Inpatient Surgical Management of Vaginal Prolapse, Rectal Prolapse, and Concurrent Vaginal and Rectal Prolapse Surgery
Objective To report age- and population-adjusted trends in the prevalence of inpatient vaginal prolapse (VP), rectal
prolapse (RP), and concurrent VP/RP surgical procedures in women in Washington State over a 12-year period.
Methods The Comprehensive Hospital Abstract Reporting System, an inpatient claims database, was queried for
female patients aged 20 years or older with a diagnosis of VP and/or RP and associated surgical procedures from 2008
to 2019. Rates for female patients were adjusted by age and population based on census results.
Results Between 2008 and 2019, inpatient admissions for concurrent VP/RP surgery remained stable, with adjusted
rates ranging from 1.42 to 3.38 per 100 000, with a majority performed in patients < 80 years old. The populationadjusted
rate of inpatient RP repairs remained stable at 3.12 to 5.14 per 100 000. The population-adjusted rate of
inpatient VP repairs decreased dramatically, from 81.79 to 6.96 per 100 000.
Conclusions The rate of inpatient RP and combined RP/VP surgical procedures was low and remained stable,
while inpatient VP surgical repairs decreased substantially. Since the dataset is limited to inpatient surgery, this trend
may reflect a shift to outpatient settings for VP surgeries. Nationally in the United States, there has been a trend
toward multidisciplinary surgical management of concurrent VP/RP. However, this same trend does not appear to
be reflected in Washington State, suggesting that nationwide trends may not be reflective of trends within each state.
Further study is needed to understand how and why local trends in the management concurrent VP/RP may differ
from national trends, and potentially improve concurrent VP/RP management using multidisciplinary approaches.
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