Association Between Primary Language, Pelvic Organ Prolapse Stage, and Treatment

Area of Science:

• Urogynecology
• Health Services Research

Background:

• Communication barriers impact healthcare access for non-English primary language (NEPL) individuals.
• Limited research exists on the association between primary spoken language (PSL) and pelvic organ prolapse (POP) outcomes.
• Suboptimal counseling can occur due to language barriers in specialized care.

Purpose of the Study:

• To investigate the association between primary language and the severity and management of POP.
• To determine if language influences treatment decisions for pelvic organ prolapse.

Main Methods:

• Retrospective cohort analysis of 114 patients evaluated for POP between 2015-2023 at two tertiary care centers.
• Patients were categorized into non-English primary language (NEPL) and English primary language (EPL) groups.
• Data collected included demographics, Pelvic Organ Prolapse Quantification (POP-Q) examination results, and treatment within six months.

Main Results:

• The NEPL group had higher rates of gravidity, parity, Medicaid/Medicare/Self-pay insurance, and diabetes mellitus.
• Rates of advanced-stage POP (stage 3-4) were similar between NEPL and EPL groups (49.1% vs 56.1%).
• NEPL patients showed significantly higher rates of apical, anterior, and posterior prolapse, yet were less likely to undergo surgical management (22.8% vs 43.9%).

Conclusions:

• Inequity in POP treatment based on primary language was observed.
• NEPL patients with POP face higher prolapse rates but receive conservative management more often, suggesting potential bias.
• Further research is needed to address disparities in care for NEPL populations with POP.