International urogynecology journal · 2026
Racial and Ethnic Disparities in Surgical Timing and Preoperative Care for Urinary Incontinence: a Large Single Academic Institution Study in the USA.
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Shen Julia, Ghandour Rachan, Micussi Maria, Marses Angela, Ovsepian Susanna, Krafian Knar, Aljamal Sasha, Minassian Vatche A
Аннотация
INTRODUCTION AND HYPOTHESIS: This retrospective cohort study examined racial/ethnic differences in time from initial presentation with urinary incontinence (UI) to surgery and number of clinical visits prior to sling surgery for UI.
METHODS: Electronic health records were accessed for patients aged 18 years or older who underwent sling procedures for UI over a 134-month period at a single academic institution. The primary outcome was lead time to surgery (LTTS), the number of days between the first clinical visit for UI and the anti-incontinence surgery. The secondary outcome was the number of UI-related clinical visits prior to surgery. ANOVA and multivariable linear regression analyses were used to identify independent predictors.
RESULTS: A total of 4246 patients were analyzed. On univariate analysis, Black patients had the longest LTTS (462.8 ± 735.7 days) compared with white patients (302.2 ± 496.8 days) and "Other" patients (226.4 ± 429.4 days; p < 0.01). However, multivariable regression revealed that racial/ethnic differences in LTTS were not statistically significant after controlling for confounders (β = 11.13, p = 0.41). Instead, age and UI severity were identified as significant predictors of LTTS. Age was inversely associated with LTTS (β = -2.53, p < 0.02), and greater UI severity was associated with shorter LTTS (β = -21.93, p = 0.03). Notably, racial/ethnic differences in preoperative visit frequency remained significant in adjusted models; Asian and Hispanic patients had, on average, 0.90 (p < 0.01) and 0.58 (p < 0.01) more visits respectively than white patients.
CONCLUSIONS: Although lead time to UI surgery did not differ by race/ethnicity after adjustment, Asian and Hispanic patients had significantly more preoperative visits prior to surgery.
METHODS: Electronic health records were accessed for patients aged 18 years or older who underwent sling procedures for UI over a 134-month period at a single academic institution. The primary outcome was lead time to surgery (LTTS), the number of days between the first clinical visit for UI and the anti-incontinence surgery. The secondary outcome was the number of UI-related clinical visits prior to surgery. ANOVA and multivariable linear regression analyses were used to identify independent predictors.
RESULTS: A total of 4246 patients were analyzed. On univariate analysis, Black patients had the longest LTTS (462.8 ± 735.7 days) compared with white patients (302.2 ± 496.8 days) and "Other" patients (226.4 ± 429.4 days; p < 0.01). However, multivariable regression revealed that racial/ethnic differences in LTTS were not statistically significant after controlling for confounders (β = 11.13, p = 0.41). Instead, age and UI severity were identified as significant predictors of LTTS. Age was inversely associated with LTTS (β = -2.53, p < 0.02), and greater UI severity was associated with shorter LTTS (β = -21.93, p = 0.03). Notably, racial/ethnic differences in preoperative visit frequency remained significant in adjusted models; Asian and Hispanic patients had, on average, 0.90 (p < 0.01) and 0.58 (p < 0.01) more visits respectively than white patients.
CONCLUSIONS: Although lead time to UI surgery did not differ by race/ethnicity after adjustment, Asian and Hispanic patients had significantly more preoperative visits prior to surgery.