Social Vulnerability Index and Surgical Management of Pelvic Organ Prolapse

The aim of this study was to determine whether the Social Vulnerability Index (SVI) is associated with the type of surgery for pelvic organ prolapse (POP) focusing on sacrocolpopexy (SCP) and uterosacral ligament suspension (USLS).

This was a retrospective case-control study that included patients from 8 hospitals within a large academic health system in New York between January 1, 2018 and January 1, 2023. All patients 15-85 years of age with a preoperative diagnosis of POP who underwent a hysterectomy with an SCP or USLS were included. Home addresses were linked to census tracts and SVI scores. Multiple logistic regression analyses were performed to evaluate the association between SVI quartiles and POP surgical management (SCP vs USLS).

Six hundred one patients who underwent reconstructive surgery for POP were included in the study. The Social Vulnerability Index was not statistically significantly associated with POP surgical management ( P = 0.26). After adjusting for potential confounders, there continued to be no association between SVI and POP management ( P = 0.40). The adjusted model illustrated that age 65 years or greater was associated with decreased odds (adjusted odds ratio, 0.24; 95% confidence interval, 0.14-0.40) of SCP ( P < 0.0001), whereas patients with hypertension were found to be at increased odds (adjusted odds ratio, 2.60; 95% confidence interval, 1.01-6.71).

There was no statistically significant association between SVI and POP surgical management for SCP versus USLS. However, advanced patient age (65 years and greater) was associated with decreased odds, and hypertension was associated with greater odds of SCP.