Trends in use of surgical mesh for pelvic organ prolapse.

Trends in use of surgical mesh for pelvic organ prolapse.
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DOI:
10.1016/j.ajog.2012.11.008
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发表时间:
2013-01
影响因子:
9.8
通讯作者:
Wu, Jennifer M.
Wu, Jennifer M.
中科院分区:
医学1区
文献类型:
--
作者:
Funk, Michele Jonsson;Edenfield, Autumn L.;Pate, Virginia;Visco, Anthony G.;Weidner, Alison C.;Wu, Jennifer M.

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Limited data exist on the rates of pelvic organ prolapse procedures utilizing mesh. The objective of this study was to examine trends in vaginal mesh prolapse procedures (VM), abdominal sacrocolpopexy (ASC) and minimally-invasive sacrocolpopexy (MISC) from 2005–2010. We utilized de-identified, adjudicated healthcare claims data from across the United States from 2005–2010. Among women ≥18 years, we identified all mesh prolapse procedures based on CPT codes (57267 for VM, 57280 for ASC and 57425 for MISC). VM procedures included all vaginal prolapse surgeries in which mesh was placed, whether in the anterior, apical or posterior compartment. We estimated rates per 100,000 person-years (100,000py) and 95% confidence intervals (95% CI). During 78.5 million person-years of observation, we identified 60,152 mesh prolapse procedures, for a rate of 76.0 per 100,000py 100,000py (95% CI: 73.6, 78.5). Overall, VM comprised 74.9% of these surgeries for an overall rate of 56.9 per 100,000py (95% CI: 55.0, 58.9). Rates of ASC and MISC were considerably lower at 12.0 per 100,000py (95% CI: 11.6, 12.5) and 9.5 per 100,000py (95% CI: 9.2, 9.9), respectively. Among sacrocolpopexies, ASC was more common than MISC in 2005–2007; however, since 2007, the rate of MISC has increased while the rate of ASC has decreased. Regarding trends by age, VM was considerably more common than sacrocolpopexies at all ages, and ASC was more common than MISC in women over 50 years. From 2005 to 2010, the rate of mesh prolapse procedures has increased, with vaginal mesh surgeries constituting the vast majority.
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