Treatment of Stress Urinary Incontinence: Does Race Matter?

Importance The importance of this study was to examine treatment patterns and surgical complications for stress urinary incontinence (SUI). Objectives The aim of this study was to describe the treatment of SUI and associated complications in a racially and ethnically diverse population. Study Design This was a retrospective cohort study of patients with a new diagnosis of SUI. We identified patients who received treatment with a pessary, pelvic floor physical therapy, or surgery. Surgical complications were abstracted. Logistic regression was used to examine the association between race/ethnicity and treatment, as well as surgical complications. Results A total of 67,187 patients with a new diagnosis of SUI were included. The population was predominately Hispanic (47.5%) followed by White, Asian, Black, Native Hawaiian/Pacific Islander, and American Indian/Alaska Native. Comparing no treatment to any treatment, all racial/ethnic groups, except American Indian/Alaska Native, had decreased odds of receiving treatment compared with White women. Hispanic and Native Hawaiian/Pacific Islander women had increased odds of referral for pelvic floor physical therapy compared with White women. All racial/ethnic groups, except for American Indian/Alaska Native women, had decreased odds of receiving a sling procedure compared with White women. When these racial/ethnic minority groups did receive treatment, it was more likely to be conservative treatment compared with White women. There were no significant differences in individual surgical complications. Conclusions Racial minority women were 20–50% less likely to undergo a sling procedure, commonly posited as the gold standard surgical treatment. Racial minority women were 40–100% more likely to receive conservative management and 20–50% less likely to receive any treatment compared with White women.