ABSTRACT Background The current literature summarizes the trends in the surgical management of stress urinary incontinence (SUI) and not the general trends of management for all UI types in the US. Additionally, recent evidence on racial and ethnic disparities in UI related surgical utilization is limited. Objective To describe the currently prescribed and performed therapeutic and surgical treatments, and to assess racial and ethnic disparities in receiving treatment for female patients with urinary incontinence (UI). Design A retrospective observational study. Participants and Measures We used a University Medical Center electronic health care data from 2012 to 2022. We included females ≥ 18 years old diagnosed with stress, urge, or mixed UI, who received at least one pharmacologic or surgical treatment of interest. Our primary outcome was the frequency of the medications (Antimuscarinics and b3‐adrenergic agonists) and surgical (sling, Burch, bulking agent surgeries) treatment for female patients with UI. Racial and ethnic disparities in receiving treatment were also assessed using logistic regressions. Results A total of 138,752 female patients were diagnosed with UI from 2012 to 2022. Oxybutynin was the most frequently prescribed medication in this study, with 77,920 prescriptions, followed by mirabegron with 48,052 prescriptions. A total of 23,898 UI surgeries were performed. Of these, sling accounted for 78.10%, then bulking agent surgery (15.7%) and Burch (6.83%). Blacks or African Americans (OR: 0.814, p : < 0.0001) and Asians (OR: 0.865, p : 0.0228) had lower odds of receiving UI procedures compared to Whites. Blacks or African Americans were also more likely to get oxybutynin and less likely to get mirabegron to treat UI compared to Whites. Also, Ethnic disparities exist in receiving treatment. Conclusion Sling was consistently the most performed surgery every year for female patients with UI. Oxybutynin and mirabegron were the most prescribed medications. Racial and ethnic health disparities were shown in receiving treatment.
Almadfaa et al. (Mon,) studied this question.