Incontinence Treatment Trends Changed in the 1990s

Needle suspension became less common; rates of sling placements increased drastically

14 aug 2009 -- Trends in the surgical management of stress urinary incontinence among women in the United States changed rapidly from 1992 to 2001, according to a study in the August issue of Urology.

Jennifer T. Anger, M.D., of the University of California in Los Angeles, and colleagues analyzed data from a 5 percent national random sample of female Medicare beneficiaries aged 65 years and older. The data came from the Centers for Medicare and Medicaid Services' carrier and outpatient files from 1992, 1995, 1998 and 2001.

The number of surgical procedures for stress urinary incontinence increased over the period from 18,820 to 32,480. The researchers note that this was likely due to the growing number of Medicare beneficiaries. Needle suspension was the most commonly performed procedure in 1992 and 1995, but, by 1998, collagen injections had become most common. In addition, the investigators found that the numbers and rates of sling placements increased drastically from 1995 to 2001.

"As in previous years, we identified a trend toward minimally invasive approaches to surgery, without the presence of randomized controlled clinical trials to support these trends," the authors write. "We anticipate that the analysis of Medicare claims from 2004 onward will demonstrate an additional increase in the use of sling procedures."

Abstract
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