TY - JOUR
T1 - Trends in Mesh Use for Pelvic Organ Prolapse Repair From the Medicare Database
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.
N1 - Publisher Copyright:
© 2015
PY - 2015/11
Y1 - 2015/11
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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U2 - 10.1016/j.urology.2015.08.022
DO - 10.1016/j.urology.2015.08.022
M3 - Article
C2 - 26344153
AN - SCOPUS:84983543669
SN - 0090-4295
VL - 86
SP - 885
EP - 891
JO - Urology
JF - Urology
IS - 5
ER -