Trends in Mesh Use for Pelvic Organ Prolapse Repair From the Medicare Database

Lily C. Wang, Bashir Al Hussein Al Awamlh, Jim C. Hu, Melissa A. Laudano, Wesley L. Davison, Michael L. Schulster, Fujun Zhao, Bilal Chughtai, Richard K. Lee

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Objective To investigate recent trends in mesh use for pelvic organ prolapse (POP)-related reconstruction procedures. Materials and Methods Using the 2001-2011 5% Medicare claims database, we identified POP diagnoses and related procedures. Transvaginal mesh use and sacrocolpopexy were first reported in 2005 and 2004, respectively. Results A total of 613,160 cases of vaginal and abdominal POP repair procedures were identified. The majority of procedures involved multiple compartments. The rate of mesh use increased dramatically from 2% of repairs in 2005 to 35% by 2008. After the Food and Drug Administration warning in 2008, mesh use plateaued and then decreased in 2011. Mesh was used more commonly in younger (odds ratio [OR] 0.722, P <.001), white (OR 0.712-0.791 for other races, P <.001) women in the South (OR 0.741-0.848 for non-South regions, P <.001). Starting in 2008, the rate of sacrocolpopexy procedures almost doubled yearly until 2011. Sacrocolpopexy was more common in younger patients (49% in women <70 years) and in white women (88%); the majority of sacrocolpopexies were performed in the South (60%) and laparoscopically (83%-98%). Conclusion The treatment of POP has changed over time. The use of mesh increased significantly until 2008, after which it plateaued following the Food and Drug Administration warning regarding mesh-related complications. Concurrently, the number of sacrocolpopexy procedures increased significantly starting in 2008 as the use of laparoscopic and/or robotic technique and concern regarding transvaginal mesh increased.

Original languageEnglish (US)
Pages (from-to)885-891
Number of pages7
JournalUrology
DOIs
StatePublished - Nov 1 2015
Externally publishedYes

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Pelvic Organ Prolapse
Medicare
Databases
Odds Ratio
United States Food and Drug Administration
Robotics

ASJC Scopus subject areas

  • Urology

Cite this

Wang, L. C., Al Hussein Al Awamlh, B., Hu, J. C., Laudano, M. A., Davison, W. L., Schulster, M. L., ... Lee, R. K. (2015). Trends in Mesh Use for Pelvic Organ Prolapse Repair From the Medicare Database. Urology, 885-891. https://doi.org/10.1016/j.urology.2015.08.022

Trends in Mesh Use for Pelvic Organ Prolapse Repair From the Medicare Database. / Wang, Lily C.; Al Hussein Al Awamlh, Bashir; Hu, Jim C.; Laudano, Melissa A.; Davison, Wesley L.; Schulster, Michael L.; Zhao, Fujun; Chughtai, Bilal; Lee, Richard K.

In: Urology, 01.11.2015, p. 885-891.

Research output: Contribution to journalArticle

Wang, LC, Al Hussein Al Awamlh, B, Hu, JC, Laudano, MA, Davison, WL, Schulster, ML, Zhao, F, Chughtai, B & Lee, RK 2015, 'Trends in Mesh Use for Pelvic Organ Prolapse Repair From the Medicare Database', Urology, pp. 885-891. https://doi.org/10.1016/j.urology.2015.08.022
Wang LC, Al Hussein Al Awamlh B, Hu JC, Laudano MA, Davison WL, Schulster ML et al. Trends in Mesh Use for Pelvic Organ Prolapse Repair From the Medicare Database. Urology. 2015 Nov 1;885-891. https://doi.org/10.1016/j.urology.2015.08.022
Wang, Lily C. ; Al Hussein Al Awamlh, Bashir ; Hu, Jim C. ; Laudano, Melissa A. ; Davison, Wesley L. ; Schulster, Michael L. ; Zhao, Fujun ; Chughtai, Bilal ; Lee, Richard K. / Trends in Mesh Use for Pelvic Organ Prolapse Repair From the Medicare Database. In: Urology. 2015 ; pp. 885-891.
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title = "Trends in Mesh Use for Pelvic Organ Prolapse Repair From the Medicare Database",
abstract = "Objective To investigate recent trends in mesh use for pelvic organ prolapse (POP)-related reconstruction procedures. Materials and Methods Using the 2001-2011 5{\%} Medicare claims database, we identified POP diagnoses and related procedures. Transvaginal mesh use and sacrocolpopexy were first reported in 2005 and 2004, respectively. Results A total of 613,160 cases of vaginal and abdominal POP repair procedures were identified. The majority of procedures involved multiple compartments. The rate of mesh use increased dramatically from 2{\%} of repairs in 2005 to 35{\%} by 2008. After the Food and Drug Administration warning in 2008, mesh use plateaued and then decreased in 2011. Mesh was used more commonly in younger (odds ratio [OR] 0.722, P <.001), white (OR 0.712-0.791 for other races, P <.001) women in the South (OR 0.741-0.848 for non-South regions, P <.001). Starting in 2008, the rate of sacrocolpopexy procedures almost doubled yearly until 2011. Sacrocolpopexy was more common in younger patients (49{\%} in women <70 years) and in white women (88{\%}); the majority of sacrocolpopexies were performed in the South (60{\%}) and laparoscopically (83{\%}-98{\%}). Conclusion The treatment of POP has changed over time. The use of mesh increased significantly until 2008, after which it plateaued following the Food and Drug Administration warning regarding mesh-related complications. Concurrently, the number of sacrocolpopexy procedures increased significantly starting in 2008 as the use of laparoscopic and/or robotic technique and concern regarding transvaginal mesh increased.",
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AU - Wang, Lily C.

AU - Al Hussein Al Awamlh, Bashir

AU - Hu, Jim C.

AU - Laudano, Melissa A.

AU - Davison, Wesley L.

AU - Schulster, Michael L.

AU - Zhao, Fujun

AU - Chughtai, Bilal

AU - Lee, Richard K.

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N2 - Objective To investigate recent trends in mesh use for pelvic organ prolapse (POP)-related reconstruction procedures. Materials and Methods Using the 2001-2011 5% Medicare claims database, we identified POP diagnoses and related procedures. Transvaginal mesh use and sacrocolpopexy were first reported in 2005 and 2004, respectively. Results A total of 613,160 cases of vaginal and abdominal POP repair procedures were identified. The majority of procedures involved multiple compartments. The rate of mesh use increased dramatically from 2% of repairs in 2005 to 35% by 2008. After the Food and Drug Administration warning in 2008, mesh use plateaued and then decreased in 2011. Mesh was used more commonly in younger (odds ratio [OR] 0.722, P <.001), white (OR 0.712-0.791 for other races, P <.001) women in the South (OR 0.741-0.848 for non-South regions, P <.001). Starting in 2008, the rate of sacrocolpopexy procedures almost doubled yearly until 2011. Sacrocolpopexy was more common in younger patients (49% in women <70 years) and in white women (88%); the majority of sacrocolpopexies were performed in the South (60%) and laparoscopically (83%-98%). Conclusion The treatment of POP has changed over time. The use of mesh increased significantly until 2008, after which it plateaued following the Food and Drug Administration warning regarding mesh-related complications. Concurrently, the number of sacrocolpopexy procedures increased significantly starting in 2008 as the use of laparoscopic and/or robotic technique and concern regarding transvaginal mesh increased.

AB - Objective To investigate recent trends in mesh use for pelvic organ prolapse (POP)-related reconstruction procedures. Materials and Methods Using the 2001-2011 5% Medicare claims database, we identified POP diagnoses and related procedures. Transvaginal mesh use and sacrocolpopexy were first reported in 2005 and 2004, respectively. Results A total of 613,160 cases of vaginal and abdominal POP repair procedures were identified. The majority of procedures involved multiple compartments. The rate of mesh use increased dramatically from 2% of repairs in 2005 to 35% by 2008. After the Food and Drug Administration warning in 2008, mesh use plateaued and then decreased in 2011. Mesh was used more commonly in younger (odds ratio [OR] 0.722, P <.001), white (OR 0.712-0.791 for other races, P <.001) women in the South (OR 0.741-0.848 for non-South regions, P <.001). Starting in 2008, the rate of sacrocolpopexy procedures almost doubled yearly until 2011. Sacrocolpopexy was more common in younger patients (49% in women <70 years) and in white women (88%); the majority of sacrocolpopexies were performed in the South (60%) and laparoscopically (83%-98%). Conclusion The treatment of POP has changed over time. The use of mesh increased significantly until 2008, after which it plateaued following the Food and Drug Administration warning regarding mesh-related complications. Concurrently, the number of sacrocolpopexy procedures increased significantly starting in 2008 as the use of laparoscopic and/or robotic technique and concern regarding transvaginal mesh increased.

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