Introduction Following concerns with mesh material and an increase in the use of injectable agents for stress urinary incontinence (SUI), we reviewed the Cerner Real World Database (CRWD) regarding SUI surgical procedures for women since 2016. The CRWD is a big data source from multi-center electronic health records (EHRs) spanning 2,222 facilities across the nation and de-identified data from over 100 million patients . Methods De-identified EHRs from CRWD were reviewed for anti-SUI procedures in women from 2016 to 2024. Relevant CPT and ICD codes were used to identify cases. Key demographic information was collected and analyzed. Annual incidence of women diagnosed and treated for SUI by region in the United States was calculated. Results A total of 222,693 women met study criteria. From 2016 to 2024, sling utilization declined while the use of injectable treatments increased, rising from 15% to 24% of all SUI procedures and slings decreasing from 83% to 76%. Procedure rates per 100 women with SUI showed a significant rise in injectables and a post-2021 decline in sling use, with no reduction in overall treatment rates during the COVID-19 pandemic. Significant regional variation was observed when analyzing which procedures were used (p < 0.0001). Conclusion This study highlights a significant decline in sling procedures for SUI treatment from 2016 to 2024, accompanied by a rise in injectable therapies. Multiple factors may play a part in regional variation of SUI procedures performed.
Seyan et al. (Mon,) studied this question.