Racial Disparities in Pelvic Floor Disorders.

Abstract

Objective: To investigate the impact of racial disparities and socioeconomic status on pelvic floor disorder (PFD) care.

Background: Racial disparities in colorectal PFD remain uninvestigated, despite prior research in urogynecology.

Methods: This retrospective study was conducted at Guy's and St. Thomas' Hospital of London in 2023. Patients with colorectal PFD from 2013 to 2018 were evaluated. Patients were classified according to the Index of Multiple Deprivation (IMD) scores and divided into quintiles. The lowest quintile represents the most deprived, whereas the higher quintile represents the least deprived. Assessed variables are: patient complaints, symptoms, consultant and biofeedback referrals, investigations, multidisciplinary meeting (MDM) discussions, treatment, and follow-up appointments.

Results: A total of 2001 patients were considered. A total of 1126 patients were initially analyzed, and 875 patients were excluded owing to incomplete data. Eight ethnic groups were identified in this study. Constipation was the most common complaint across ethnic groups ( P = 0.03). Diagnostics, MDM discussions, and conservative treatment did not vary among ethnicities. White British and Asian patients were significantly more likely to be seen by a consultant ( P = 0.001) and undergo surgery ( P = 0.002). In the second part of the study, the IMD was calculated for 1992 patients who were categorized into quintiles. Diagnostic tests, discussion in MDM, consultant review, and surgical treatments were significantly lower in the 2 lowest quintiles ( P < 0.001, P < 0.001, P = 0.02, and P = 0.02, respectively). Conservative treatment did not vary between the IMD groups.

Conclusions: Disparities in the diagnosis and treatment of colorectal PFD exist among ethnic minorities and patients of low socioeconomic status. This study allows for the replication of service provision frameworks in other affected areas to minimize inequalities.