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Anogenital Distance and Perineal Measurements of the Pelvic Organ Prolapse POP Quantification System
Published on: September 20, 2018
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Association of Neighborhood-Level Socioeconomic Status With Prolapse Management Decision
Perrin Downing1, Shirley M Dong1, Melissa A Ardizzone2
1From the Female Pelvic Medicine and Reconstructive Surgery, Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH.
Urogynecology (Philadelphia, Pa.)
|March 14, 2024
Summary
Neighborhood socioeconomic status impacts pelvic organ prolapse (POP) treatment choices. Women in disadvantaged areas were 67% more likely to opt for surgery over conservative management for POP.
Area of Science:
- Urogynecology and Pelvic Reconstructive Surgery
- Health Services Research
- Socioeconomic Determinants of Health
Background:
- Pelvic organ prolapse (POP) affects a significant number of women, with treatment decisions influenced by various factors.
- Understanding the role of socioeconomic status (SES) in treatment selection is crucial for equitable healthcare delivery.
- Neighborhood-level SES may represent a significant, yet understudied, determinant of POP management choices.
Purpose of the Study:
- To investigate the association between neighborhood-level socioeconomic status (SES) and the choice between surgical and conservative management for pelvic organ prolapse (POP).
- To determine if patients residing in areas with higher socioeconomic disadvantage are more or less likely to select surgical intervention for POP.
Main Methods:
- Retrospective cohort study of 459 patients diagnosed with POP between 2015 and 2021.
- Neighborhood-level SES was assessed using the Area Deprivation Index (ADI) derived from patient zip codes.
- Logistic regression models were employed to analyze the odds of choosing surgical versus conservative management based on ADI, adjusting for relevant covariates.
Main Results:
- Women residing in more socioeconomically disadvantaged areas demonstrated a 67% increased odds of selecting surgical management for POP compared to those in less disadvantaged areas (aOR, 1.67; 95% CI, 1.06-2.64).
- Increasing age and higher Pelvic Organ Prolapse Quantification System (POP-Q) stage were also significantly associated with choosing surgery.
- The majority of patients (74.7%) opted for surgical management, while 25.3% chose conservative approaches.
Conclusions:
- Neighborhood socioeconomic disadvantage is significantly associated with an increased likelihood of opting for surgical intervention in pelvic organ prolapse (POP) management.
- These findings highlight potential disparities in POP treatment based on socioeconomic factors at the neighborhood level.
- Further research is warranted to explore the mechanisms driving this association and to develop targeted interventions to ensure equitable POP care.
