Related Experiment Video
Updated: Nov 11, 2025
Author Spotlight: Advancing Pelvic Prolapse Treatment with a Non-Mesh Approach using Laparoscopic Pectopexy
Published on: October 25, 2024
Racial disparities in complications and costs after surgery for pelvic organ prolapse
Oluwateniola Brown1, Tsung Mou2, Kimberly Kenton2
1Division of Female Pelvic Medicine and Reconstructive Surgery, Northwestern University, 250 E Superior Street, Suite 05-2370, Chicago, IL, 60611, USA. Teni.e.brown@gmail.com.
Insights
Black women experienced higher inpatient surgical complication rates for pelvic organ prolapse (POP) compared to white women. Hispanic women had fewer complications and lower costs after POP surgery.
Area of Science:
- Urogynecology
- Surgical Outcomes
- Health Disparities
Background:
- Pelvic organ prolapse (POP) affects a significant number of women, necessitating surgical intervention.
- Understanding racial disparities in surgical outcomes and costs is crucial for equitable healthcare.
- Previous research has not fully elucidated the impact of race on inpatient complications and costs following POP surgery.
Purpose of the Study:
- To investigate the association between race and in-hospital postoperative complications after pelvic organ prolapse (POP) surgery.
- To examine the impact of race on the total hospital costs associated with inpatient POP surgery.
- To identify potential racial differences in surgical outcomes and healthcare expenditures for POP.
Main Methods:
- Retrospective cohort study of women undergoing inpatient POP surgery between 2012 and 2014.
- Extraction of patient demographics, outcomes, hospital characteristics, and costs.
- Comparison of characteristics by race using Kruskal-Wallis and Chi-squared tests; multivariate logistic and linear regressions to identify predictors of complications and costs.
Main Results:
- A total of 29,347 women were included; 15% experienced postoperative complications.
- Black women had significantly higher complication rates (20%) compared to white (16%), Hispanic (11%), and other races (13%).
- After multivariate analysis, Black race remained associated with increased complication odds (aOR 1.21), while Hispanic and other races showed decreased odds relative to white race. Hispanic women incurred lower hospital costs.
Conclusions:
- Black women undergoing inpatient POP surgery face a 21% increased risk of complications compared to white women.
- Hispanic women demonstrated the lowest odds of complications and the lowest associated hospital costs.
- Racial disparities exist in both complications and costs following inpatient pelvic organ prolapse surgery.
Introduction And Hypothesis:
The study objective was to examine the impact of race on inpatient complications and costs after inpatient surgery for pelvic organ prolapse (POP).
Methods:
In this retrospective cohort study, we identified women who underwent surgery for POP between 2012 and 2014. Patient demographics, outcomes, hospital characteristics, and hospital costs were extracted. Demographic and clinical characteristics were compared by race using Kruskal-Wallis for continuous variables and Chi-squared test for categorical variables. Multivariate logistic and linear regressions were used to identify variables associated with increased complications and costs respectively.
Results:
A total of 29,347 women with a median age of 62 years underwent inpatient surgery for POP between 2012 and 2014. There were 4,419 women (15%) who had at least one in-hospital postoperative complication. Rates of any postoperative complication were significantly higher among Black women (20%) than among white, Hispanic, and women of other races (16%, 11%, and 13% respectively, p < 0.01). The median total cost associated with surgeries for POP was $8,267 (IQR $6,008-$11,734). After multivariate analyses controlled for potential confounders, postoperative complications remained independently associated with Black race (aOR 1.21) whereas Hispanic and other races were associated with decreased odds of complications (aOR 0.62, and aOR 0.77) relative to white race. After controlling for confounders, Hispanic women had lower associated hospital costs.
Conclusions:
Black women undergoing inpatient surgery for POP had a 21% increase in the odds of complications, but no difference in costs compared with white women, whereas Hispanic women had the lowest odds of complications and lowest costs.
Related Concept Videos
01:25Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications
01:19Abdominal Regions and Quadrants
The simpler quadrants approach, which is more commonly used in medicine, subdivides the cavity with one horizontal and one vertical line that intersects at the patient's umbilicus (navel). The four...
01:25Urinary Tract Calculi VI: Surgical Management