Racial Disparities in Sacral Neuromodulation for Idiopathic Fecal Incontinence. Urogynecology (Phila) 2024 Nov 01;30(11):873-879
Date
05/06/2024Pubmed ID
38710021DOI
10.1097/SPV.0000000000001520Scopus ID
2-s2.0-85200011872 (requires institutional sign-in at Scopus site) 6 CitationsAbstract
IMPORTANCE: Sacral neuromodulation (SNM) is an effective treatment for fecal incontinence (FI). Previous studies found that Black women undergo SNM for urinary incontinence less than White women, but there is less known about racial disparities for FI.
OBJECTIVE: This study assessed differences in Black and White patients' FI treatment; SNM counseling was the primary outcome.
STUDY DESIGN: This was a retrospective cohort study of adult non-Hispanic Black and White patients who received FI treatment at an academic institution from 2011 to 2021. Medical records were queried for treatments, testing, and treating specialties for a 2:1 age-matched cohort of White:Black patients.
RESULTS: Four hundred forty-seven women were included: 149 Black women and 298 age-matched White women. A total of 24.4% (109) of patients had documented SNM counseling, significantly fewer in Black patients (14.8% vs 29.2%, P < 0.001). A total of 5.1% (23) of patients received SNM, less frequent in Black patients (2.7% vs 6.4%, P = 0.003). Among patients with SNM counseling, there was no difference between cohorts. Black patients were less likely to be referred for physical therapy (59.7% vs 77.2%, P < 0.001), sphincter imaging (0.7% vs 5.7%, P = 0.011), and defecography (8.1% vs 17.1%, P = 0.009). Different specialties managed the 2 cohorts. Black patients were less likely to see urogynecology and colorectal surgery (21.5% vs 34.6%, P = 0.004; 9.4% vs 15.4%, P = 0.077). Patients seen by these surgeons were more likely to discuss SNM (48.6% vs 8.5%, P < 0.001).
CONCLUSIONS: There were differences between Black and White patients' FI treatment, including counseling about SNM. Multidisciplinary work is needed to provide equitable education for this life-altering condition.
Author List
Seitz V, Calata J, Mei L, Davidson ERWAuthors
Jed Calata MD Assistant Dean, Associate Professor in the Surgery department at Medical College of WisconsinEmily Davidson BS, MD Associate Professor in the Obstetrics and Gynecology department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdultAged
Counseling
Electric Stimulation Therapy
Fecal Incontinence
Female
Healthcare Disparities
Humans
Lumbosacral Plexus
Middle Aged
Retrospective Studies
Sacrum
