Emergency department visits for undiagnosed pelvic organ prolapse.

Abstract

Objectives: To describe women presenting to the emergency department (ED) for previously undiagnosed pelvic organ prolapse (POP). Secondary objective was to determine rates of outpatient specialty follow-up and factors associated with accessing follow-up care.

Study design: Retrospective study of patients who presented at 3 EDs affiliated with an urban academic health system that received a new diagnosis of POP between January 2016 and September 2022. Data on demographics, chief complaint, evaluation and interventions performed in the ED, and follow-up care within 3 months post-ED discharge were abstracted from the medical chart. Descriptive statistics and bivariate analyses were used to compare characteristics of women who did and did not follow-up for specialty or subspecialty care.

Results: 56 patients met inclusion criteria. Mean age was 61.2 ± 17.1 years. The majority identified as either non-Hispanic Black (51.8 %) or Hispanic or Latino (25.0 %). 57.1 % of patients had public insurance. Less than half (42.8 %) of patients underwent follow-up care with a urogynecologist or gynecologist within 3 months after ED discharge. Race was found to be significantly associated with follow-up rates (P = 0.03), with non-Hispanic Black women experiencing the lowest rates (20.7 %) of follow-up.

Conclusions: POP causes sufficient distress to prompt an ED encounter. A subset of women overrepresented by Black and publicly insured women utilize the ED for initial POP evaluation, when compared to patients who access initial outpatient POP care. A minority of patients underwent outpatient follow-up. Further research is needed to understand care-seeking behaviors for POP and barriers to timely outpatient follow-up care.