Urogynecology (Hagerstown, Md.)最新文献

{"title":"Prevalence and Clinical Correlates of Endometriosis in Patients With IC/BPS.","authors":"Mary Namugosa, Amr El Haraki, Rory Ritts, Kaylee Ferrara, Gopal Badlani, Robert Evans, Stephen J Walker","doi":"10.1097/SPV.0000000000001589","DOIUrl":"10.1097/SPV.0000000000001589","url":null,"abstract":"<p><strong>Importance: </strong>Interstitial cystitis/bladder pain syndrome (IC/BPS) presents as a complex heterogeneous disorder that poses a significant clinical challenge both for diagnosis and treatment. The identification of patient subgroups with significant overlap in their nonurological associated symptoms, including endometriosis, may enable a more targeted therapeutic approach.</p><p><strong>Objective: </strong>This study investigated the prevalence, clinical correlates, and clinical sequelae associated with concurrent endometriosis in patients with IC/BPS.</p><p><strong>Study design: </strong>Demographic, clinical, surgical, and questionnaire data from female patients (n = 533) with a diagnosis of IC/BPS were evaluated in this retrospective cohort study. Surgical history was obtained from patient electronic medical records, using Current Procedural Terminology (CPT) and International Classification of Diseases (ICD) codes. Data from participants with and without concurrent endometriosis were compared using univariate analysis, followed by binary logistic regression to identify associated variables.</p><p><strong>Results: </strong>Of 533 participants, 108 (20.3%) reported a history of endometriosis. Those with concurrent endometriosis were younger, had a larger bladder capacity, and had a higher number of nonurological associated symptoms. Patients with concurrent endometriosis were less likely to have a history of cystectomy (the surgical removal of the bladder) and report allergies but more prone to report comorbidities such as chronic pelvic pain, chronic fatigue, fibromyalgia, migraines, and pelvic floor dysfunction. Binary logistic regression identified a positive association between endometriosis and chronic pelvic pain, and a negative association between allergies and low bladder capacity for those with concurrent endometriosis.</p><p><strong>Conclusions: </strong>Endometriosis is common in younger female patients with IC/BPS and is associated with a non-bladder-centric (ie, systemic pain disorder) phenotype.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"131-138"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Smoking's Impact on 30-Day Complications in Mesh and Nonmesh Prolapse Surgery.","authors":"Tara D Marczak, Mallika Anand, Yi Hsieh, Ayodele Ajayi, Michele R Hacker, William D Winkelman","doi":"10.1097/SPV.0000000000001658","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001658","url":null,"abstract":"<p><strong>Importance: </strong>Tobacco smoking is linked to poor surgical outcomes, leading many physicians to avoid synthetic implants like mesh in smokers due to concerns about impaired healing. While long-term outcomes for smokers have been studied, the effect of smoking on 30-day postoperative complications, especially related to surgical mesh, is less understood.</p><p><strong>Objectives: </strong>This study aimed to quantify the association between tobacco smoking and risk of postoperative infection, readmission, and reoperation within 30 days of minimally invasive apical prolapse repair. We also examined whether these associations differed based on whether mesh was used.</p><p><strong>Study design: </strong>We conducted a retrospective cohort study using the American College of Surgeons National Surgical Quality Improvement Program database for patients who underwent minimally invasive apical pelvic organ prolapse repair from 2012 to 2022. Smoking in the last year was the exposure. Outcomes included postoperative infection, unplanned readmission, and reoperation within 30 days. We calculated adjusted risk ratios for complications and stratified results based on mesh use.</p><p><strong>Results: </strong>Of 67,235 cases, 5,518 (8.2%) patients smoked in the past year. Smokers had a significantly higher likelihood of infection and unplanned readmission. Smoking did not increase the risk of unplanned reoperation. The association between smoking and 30-day complications did not differ based on mesh use (all P for interaction ≥0.24).</p><p><strong>Conclusions: </strong>Tobacco use was associated with an increase in postoperative complications within 30 days, though the absolute risk was low. There was no evidence of effect modification by mesh use; suggesting that mesh-augmented repairs could be considered in smokers who receive appropriate counseling.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Mark Cuban Cost Plus Drug Company Effect on Urogynecologic Drugs.","authors":"Raymond Xu, Megan Escott, Amr Sherif El Haraki","doi":"10.1097/SPV.0000000000001653","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001653","url":null,"abstract":"<p><strong>Importance: </strong>The Mark Cuban Cost Plus Drug Company (ie, Cost Plus Drugs) is a service that makes generic drugs affordable. Cortese et al recently published the top 9 most commonly used oral medications in treatment of urologic conditions and showed that Cost Plus Drugs would have provided an estimated $1.29 billion reduction in 2020 costs if they replaced the Medicare prices.</p><p><strong>Objectives: </strong>We sought to investigate the savings for all drugs commonly used in urogynecology.</p><p><strong>Study design: </strong>We reviewed the generic drugs provided by Cost Plus Drugs and selected those commonly used for the treatment of urogynecologic conditions (N = 16). For each of the 16 drugs we identified the Cost Plus Drugs prices for the 30- and 90-count quantities. We then also calculated the 2021 Medicare spending for the 16 drugs. The potential savings were calculated as the difference between Cost Plus Drugs and Medicare 30- and 90-count prices, multiplied by the volume-adjusted number of units dispensed to Medicare beneficiaries in 2021.</p><p><strong>Results: </strong>The total estimated savings when using Cost Plus Drugs compared to Medicare was $462,375,491.53 and $618,833,850.34 for 30- and 90-count pricing, respectively. The price of a 42.5-gram tube of vaginal estrogen cream was $22.48 on Cost Plus Drugs, compared to $293.66 through Medicare Part D.</p><p><strong>Conclusions: </strong>Cost Plus Drugs is a novel program that has tremendous implications on costs savings in the context of prescription drugs and is particularly true for drugs used in the treatment of urogynecologic conditions, specifically vaginal estrogen.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obstetric Anal Sphincter Injury: Vaginal Birth After Cesarean Versus First Vaginal Delivery.","authors":"Brigid S Mumford, Lara Lemon, John Harris, Lauren E Giugale","doi":"10.1097/SPV.0000000000001647","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001647","url":null,"abstract":"<p><strong>Importance: </strong>Modern data regarding the relationship between vaginal birth after cesarean (VBAC) and obstetric anal sphincter injury (OASI) are minimal with mixed results.</p><p><strong>Objective: </strong>The aim of the study was to determine if VBAC is associated with an increased risk of OASIs.</p><p><strong>Study design: </strong>This was a retrospective cohort study of liveborn deliveries from 2018 to 2022 within a large, multihospital academic health system. The primary outcome was the proportion of OASIs compared between patients who underwent a first vaginal delivery (primiparous vaginal delivery group) versus patients who underwent a first VBAC (VBAC group).</p><p><strong>Results: </strong>A total of 17,044 patients were included. A total of 16,208 had a primiparous vaginal delivery and 836 underwent VBAC. Vaginal birth after cesarean patients were older (29.9 vs 27.0 years, P < 0.01), more likely to self-identify as Black or Asian race (26.1% vs 18.0%, P < 0.01), and had lower maternal weight (182.7 vs 187.2 lbs, P < 0.01). The proportion of OASIs was significantly higher in the VBAC group (6.9% vs 5.1%, P = 0.02). Vacuum-assisted vaginal deliveries were more common in the VBAC group (7.7% vs 5.4%, P < 0.01).On multivariable logistic regression, VBAC was not significantly associated with OASIS (odds ratio [OR] = 1.01, 95% confidence interval [CI] = 0.75-1.36, P = 0.95). Operative vaginal delivery (OR = 6.44, CI = 5.51-7.52, P < 0.01), older maternal age (OR = 1.05, CI = 1.03-1.07), and Asian race (OR 2.62, CI = 2.10-3.26) demonstrated increased odds of OASIs. Patients who identified as Black demonstrated lower odds of OASIs (OR = 0.68, CI = 0.50-0.93).</p><p><strong>Conclusions: </strong>While there was a greater proportion of OASIs in the VBAC group compared to the primiparous vaginal delivery group, VBAC was not an independent risk factor.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How do you solve a problem like mirabegron?","authors":"Lauren A Cadish, Jonathan P Shepherd","doi":"10.1097/SPV.0000000000001662","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001662","url":null,"abstract":"","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why wasn't mirabegron chosen for the first year of the CMS negotiation program?","authors":"Lauren A Cadish, Jonathan P Shepherd","doi":"10.1097/SPV.0000000000001663","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001663","url":null,"abstract":"<p><strong>Abstract: </strong>Importance: The most used overactive bladder (OAB) medications are anticholinergics, which professional societies recommend avoiding in older patients given dementia risk. Cost prevents patients from switching to preferred beta-3 agonists. Mirabegron was the only beta-3 agonist eligible for the Centers for Medicare/Medicaid Services (CMS) 2023 Drug Negotiation Program (DNP). While mirabegron's price would be markedly reduced by inclusion in the DNP, only ten drugs were chosen in its first year.Objectives: We sought to explain mirabegron's absence from CMS's 2023 DNP and estimate the percentage of anticholinergic to mirabegron conversions needed to merit DNP inclusion.Study design: We modeled CMS's 2023 selection process using publicly available dashboards from 2017-2021. Among the 20 costliest drugs, we excluded ineligible drugs and categorized the remainder as DNP chosen/not chosen. For drugs not chosen, we used price inflation and beneficiary utilization trends to project total 2023 costs.Results: In 2021, mirabegron was the 14th most costly drug overall-9th when excluding ineligibles-and the only top-20 drug eligible but not selected for the 2023 DNP. We estimated mirabegron to be 96.7% the cost of the 10th most costly drug. Switching 1.2% of 2021 anticholinergic prescriptions to mirabegron would have led to DNP inclusion, presenting an interesting dilemma where more patients would use mirabegron if it were cheaper, but insufficient patients used it for DNP inclusion to make it cheaper.Conclusions: Mirabegron came exceedingly close to DNP selection in 2023, and its future inclusion in the DNP would likely herald a massive shift of Medicare patients away from anticholinergics.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phenotypes of Pelvic Organ Prolapse.","authors":"Zoe Sayler, Katie Weston, Colin M Johnson, Victoria Cunningham, Catherine S Bradley, Kimberly A Kenne, Linder Wendt, Patrick Ten Eyck, Joseph T Kowalski","doi":"10.1097/SPV.0000000000001640","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001640","url":null,"abstract":"<p><strong>Importance: </strong>The Pelvic Organ Prolapse Quantification (POP-Q) stages do not correlate with symptoms or characterize important prolapse subtypes.</p><p><strong>Objectives: </strong>We hypothesize that clinically meaningful prolapse \"phenotypes\" utilizing POP-Q measurements can be defined. The primary aim was to define the phenotypes and their frequency. Secondary aims were to compare demographics, medical characteristics, and symptoms between phenotypes.</p><p><strong>Study design: </strong>Patients who previously underwent prolapse surgery were retrospectively categorized into 1 of 8 phenotypes based on 2 principles: (1) prolapse exists when the anterior or posterior vaginal wall descend to the hymen or the apex descends half total vaginal length, and (2) prolapse may exist in anterior, posterior, and/or apical compartments. Demographics, medical characteristics, and Pelvic Floor Distress Inventory-20 (PFDI-20) responses were compared. Linear and logistic regression models were used for comparisons.</p><p><strong>Results: </strong>The AC (anterior-predominant and apical) phenotype was most common (231 of 501 patients, 46.1%) and served as the reference for comparisons. The no prolapse, P (isolated posterior), C (isolated apical), and PC (posterior-predominant and apical) phenotypes were younger. The A (isolated anterior) phenotype was older. P, PC, and APC (anterior and posterior and apical) phenotypes had greater body mass index. The P phenotype Colorectal-Anal Distress Inventory scores were higher. Similarly, the PC phenotype had higher scores for bowel splinting and rectal prolapse. Conversely, the C phenotype total PFDI-20 scores were lower (P = 0.01). Only the APC phenotype had no significant differences in any PFDI-20 question compared with the AC phenotype.</p><p><strong>Conclusion: </strong>These phenotypes may allow for improved understanding, communication, and counseling about prolapse and prolapse treatment.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Impact of Overactive Bladder Medications on Cognition.","authors":"Darlene Vargas Maldonado, Phillip J Schulte, Laureano Rangel Latuche, Maria Vassilaki, Ronald C Petersen, John A Occhino, Brian J Linder","doi":"10.1097/SPV.0000000000001522","DOIUrl":"10.1097/SPV.0000000000001522","url":null,"abstract":"<p><strong>Importance: </strong>Emerging literature has associated the use of anticholinergic medications to cognitive decline.</p><p><strong>Objective: </strong>The aim of this study was to evaluate the association of overactive bladder medications on cognitive function with prospective longitudinal cognitive assessments.</p><p><strong>Study design: </strong>A population-based cohort of individuals 50 years and older who had serial validated cognitive assessment, in accordance with the Mayo Clinic Study of Aging, was evaluated from October 2004 through December 2021. Anticholinergic overactive bladder medications were grouped by traditional anticholinergic medications and central nervous system (CNS)- sparing anticholinergic medications and compared to no medication exposure. A linear mixed effects model with time-dependent exposures evaluated the association between overactive bladder anticholinergic medication exposure and subsequent trajectories of cognitive z-scores.</p><p><strong>Results: </strong>We included 5,872 participants with a median follow-up of 6.4 years. Four hundred forty-three were exposed to traditional anticholinergic medications, 60 to CNS-sparing medications, and 5,369 had no exposure. On multivariable analyses, exposure to any anticholinergic overactive bladder medication was significantly associated with deterioration in longitudinal cognitive scores in the language and attention assessments compared to the control cohort. Traditional anticholinergic medication exposure was associated with worse attention scores than nonexposed participants. Exposure to CNS-sparing anticholinergic medications was associated with a deterioration in the language domain compared to those unexposed. Among women, traditional anticholinergic medication exposure was associated with worse global and visuospatial scores than nonexposed participants, but this association was not identified in the CNS-sparing group.</p><p><strong>Conclusion: </strong>Exposure to anticholinergic overactive bladder medications was associated with small but significantly worse decline in cognitive scoring in the language and attention domains when compared to nonexposed individuals.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"10-17"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140864716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibiotic Duration and UTI Outcomes in Recurrent UTI Patients.","authors":"Julia Shinnick, Isabel Josephs, Johanna A Suskin, Kathryn Kurchena, Lindsey Pileika, Spencer Darveau, Matthew M Scarpaci, Cassandra Carberry","doi":"10.1097/SPV.0000000000001497","DOIUrl":"10.1097/SPV.0000000000001497","url":null,"abstract":"<p><strong>Importance: </strong>Little evidence is available to inform management of acute urinary tract infections (UTIs) in women with recurrent urinary tract infection (rUTI).</p><p><strong>Objective: </strong>This study aimed to compare the proportion of acute UTIs with persistence/relapse or recurrence based on duration of treatment antibiotics (acute UTI guideline-consistent versus extended).</p><p><strong>Study design: </strong>A retrospective noninferiority study of women with rUTI was performed at an academic tertiary referral center from January 2016 to December 2020. Exposure was UTI treatment with acute UTI guideline-consistent versus extended antibiotics. Outcomes were persistent/relapsed UTI (subsequent culture with the same pathogen requiring additional antibiotics within 4 weeks), recurrent UTI (culture with different pathogen), or resolution. Sample size was calculated under the null hypothesis that the proportion of acute UTIs with persistence/relapse or recurrence after acute UTI guideline-consistent antibiotics would be within a 10% noninferiority margin of extended duration ( α = 0.05, β = 0.20, 2-sided tests, P < 0.05 significant).</p><p><strong>Results: </strong>We included 219 patients with 553 acute UTIs. The mean ± SD number of UTIs per patient was 2.53 ± 1.88, the mean ± SD age was 68.60 ± 16.29 years, and the mean ± SD body mass index was 29.73 ± 7 (calculated as weight in kilograms divided by height in meters squared). There were no differences in prior surgical procedures postvoid residual volume, pelvic floor disorders, or preventive treatments between groups. Two-hundred sixty UTIs (260 of 553 [47%]) were treated with acute UTI guideline-consistent antibiotics. Overall, 86 of 553 UTIs (15.6%) persisted/relapsed, and 29 of 553 (5.2%) recurred. The difference in the proportions of UTIs with persistence/relapse or recurrence excluded the noninferiority margin (4.4%; 95% confidence interval, -0.04 to 6.80%). In total, 115 of 553 UTIs (20.8%) had persistence/relapse or recurrence.</p><p><strong>Conclusion: </strong>In this cohort of patients with rUTI experiencing acute UTIs, acute UTI guideline-consistent duration of antibiotics was noninferior.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"34-42"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140856808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implication of Neighborhood Deprivation Index on Pelvic Organ Prolapse Management.","authors":"Amy Alagh, Olga Ramm, Liisa L Lyon, Miranda L Ritterman Weintraub, Abigail Shatkin-Margolis","doi":"10.1097/SPV.0000000000001501","DOIUrl":"10.1097/SPV.0000000000001501","url":null,"abstract":"<p><strong>Importance: </strong>Differences in the rate of diagnosis of POP have been described based on race and ethnicity; however, there are few data available on the management and treatment patterns of POP based on multiple factors of socioeconomic status and deprivation.</p><p><strong>Objective: </strong>The objective of this study was to investigate the association between pelvic organ prolapse (POP) management and the Neighborhood Deprivation Index (NDI), a standardized multidimensional measure of socioeconomic status.</p><p><strong>Study design: </strong>This retrospective cohort study included female members of a large integrated health care delivery system who were 18 years or older and had ≥4 years of continuous health care membership from January 1, 2015, to December 31, 2019. Demographic, POP diagnosis, urogynecology consultation, and surgical treatment of POP were obtained from the electronic medical record. Neighborhood Deprivation Index data were extrapolated via zip code and were reported in quartiles, with higher quartiles reflecting greater deprivation. Descriptive, bivariate, and logistic regression analyses were conducted by NDI.</p><p><strong>Results: </strong>Of 1,087,567 patients identified, 34,890 (3.2%) had a POP diagnosis. Q1, the least deprived group, had the highest prevalence of POP (26.3%). Most patients with POP identified as White (57.3%) and represented approximately a third of Q1. Black patients had the lowest rate of POP (5.8%) and comprised almost half of Q4, the most deprived quartile. A total of 13,730 patients (39.4%) had a urogynecology consultation, with rates ranging from 23.6% to 26.4% ( P < 0.01). Less than half (12.8%) of patients with POP underwent surgical treatment, and the relative frequencies of procedure types were similar across NDI quartiles except for obliterative procedures ( P = 0.01). When controlling for age, no clinically significant difference was demonstrated.</p><p><strong>Conclusions: </strong>Differences in urogynecology consultation, surgical treatment, and surgical procedure type performed for prolapse across NDI quartiles were not found to be clinically significant. Our findings suggest that equitable evaluation and treatment of prolapse can occur through a membership-based integrated health care system.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"26-33"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11380043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140095310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}