Procedures for pelvic organ prolapse in the United States, 1979-1997

Objective: The objective of our study was to describe national rates of surgery for pelvic organ prolapse. Study Design: We used the National Hospital Discharge Survey, a federal database that samples inpatient hospitals in the United States. Data from 1979 to 1997 were analyzed for diagnoses and procedures coded with the ICD-9-CM classification system. Age-adjusted rates were calculated by using the 1990 census population and compared for change over time by using the Score test for linear trend. Results: Approximately 200,000 women undergo inpatient procedures for prolapse in the United States each year, ranging from 165,000 in 1988 to 226,000 in 1979. There was a significant decrease in the overall age-adjusted rate of procedures performed over the study period, from 2.2 to 1.5 procedures per 1000 women (P = .01). The rate of prolapse procedures for women younger than 50 years decreased by more than half (1.9 to 0.8 per 1000 women, P< .001), whereas the rate remained stable in women who were aged 50 years and older (2.7 to 3.3 per 1000 women, P = .5). Conclusion: Prolapse procedures are performed very frequently in the United States, although the rate has decreased slightly over time. (Am J Obstet Gynecol 2003;188:108-15.)