Abstract
Objectives
We sought to examine temporal trends in pelvic organ prolapse (POP) surgery in Canada.
Methods
In this observational cross-sectional study, we used diagnostic and procedure codes
from all hospitalizations and outpatient clinic visits in Canada (excluding Québec)
from 2004 to 2014 to identify and analyze data on POP surgery.
Results
There were 204 301 POP surgery visits from 2004 to 2014, and the rate of POP surgery
declined from 19.3 to 16.0 per 10 000 women during this period. The rates of “native
tissue reconstructive repair” and “hysterectomy without other procedure” declined
from 15.0 to 12.8 per 10 000 women and 2.6 to 1.6 per 10 000 women, respectively.
The rate of obliteration increased from 0.1 to 0.3 per 10 000 women (all P values for trend <0.01). Mesh procedures increased from 1.6 per 10 000 women in 2004
to 2.4 per 10 000 women in 2007 and 2008, and then declined to 1.3 per 10 000 women
in 2014. Reconstructive mesh surgery using an abdominal open approach declined, while
laparoscopic procedures increased over the period examined.
Conclusion
The rates of POP surgery declined in Canada between 2004 and 2014. An increase was
observed in obliteration procedures and in laparoscopic vaginal suspension and fixation
with mesh.
Résumé
Objectif
Nous avons cherché à analyser les tendances temporelles en matière de traitement chirurgical
du prolapsus des organes pelviens (POP) au Canada.
Méthodologie
Dans le cadre de cette étude transversale observationnelle, nous avons utilisé des
codes diagnostiques et d'intervention de toutes les hospitalisations et visites en
clinique externe au Canada (à l'exception du Québec) de 2004 à 2014 afin de recenser
et d'analyser les données sur le traitement chirurgical du POP.
Résultats
On a dénombré 204 301 visites de traitement chirurgical du POP de 2004 à 2014, et
le taux d'intervention pour cette affection est passé de 19,3 à 16,0 par 10 000 femmes
au cours de cette période. Les taux de « réparation avec les tissus natifs » et d’ « hystérectomie
sans autre intervention » sont passés de 15,0 à 12,8 par 10 000 femmes et de 2,6 à
1,6 par 10 000 femmes, respectivement. Le taux d'oblitération a augmenté, passant
de 0,1 à 0,3 par 10 000 femmes (toutes les valeurs P relatives à cette tendance sont inférieures à 0,01). Le taux d'interventions de treillis
a augmenté pour passer de 1,6 par 10 000 femmes en 2004 à 2,4 par 10 000 femmes en
2007 et 2008, pour diminuer à 1,3 par 10 000 femmes en 2014. Le taux d'interventions
reconstructives de treillis par voie d'abord ouverte abdominale a diminué, tandis
que le taux d'interventions laparoscopiques a augmenté au cours de la période examinée.
Conclusion
Le taux de traitement chirurgical du POP a diminué au Canada entre 2004 et 2014. On
a constaté une augmentation du nombre d'interventions d'oblitération et de suspension
et fixation vaginales laparoscopiques avec treillis.
Keywords
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Article info
Publication history
Published online: March 12, 2020
Footnotes
Disclosures: Dr. Lisonkova is supported by a Scholar Award from the Michael Smith Foundation for Health Research.
All authors have indicated that they meet the journal's requirements for authorship.
Identification
Copyright
© 2020 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.
