Geographical variation in rates of surgical treatment for female stress urinary incontinence in England: a national cohort study Article Swipe
Jil Billy Mamza
,
Rebecca Geary
,
Dina El‐Hamamsy
,
David Cromwell
,
Jonathan Duckett
,
Ash Monga
,
Philip Toozs‐Hobson
,
Tahir Mahmood
,
Andrew Wilson
,
Douglas G. Tincello
,
Jan van der Meulen
,
Ipek Gurol‐Urganci
·
YOU?
·
· 2019
· Open Access
·
· DOI: https://doi.org/10.1136/bmjopen-2019-029878
YOU?
·
· 2019
· Open Access
·
· DOI: https://doi.org/10.1136/bmjopen-2019-029878
Objective To examine geographic variation in use of surgery for female stress urinary incontinence (SUI), mainly midurethral mesh tape insertions, in the English National Health Service (NHS). Design National cohort study. Setting NHS hospitals. Participants 27 997 women aged 20 years or older who had a first SUI surgery in an English NHS Hospital between April 2013 and March 2016 and a diagnosis of SUI at the same time as the procedure. Methods Multilevel Poisson regression was used to adjust for geographic differences in age, ethnicity, prevalence of long-term illness and socioeconomic deprivation. Primary outcome measure Rate of surgery for SUI per 100 000 women/year at two geographic levels: Clinical Commissioning Group (CCG; n=209) and Sustainability and Transformation Partnership (STP; n=44). Results The rate of surgery for SUI was 40 procedures per 100 000 women/year. Risk-adjusted rates ranged from 20 to 106 procedures per 100 000 women/year across CCGs and 24 to 69 procedures per 100 000 women/year across the STP areas. These regional differences were only partially explained by demographic characteristics as adjustment reduced variance of surgery rates by 16% among the CCGs and 35% among the STPs. Conclusions Substantial geographic variation exists in the use of surgery for female SUI in the English NHS, suggesting that women in some areas are more likely to be treated compared with women with the same condition in other areas. The variation reflects differences in how national guidelines are being interpreted in the context of the ongoing debate about the safety of SUI surgery.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1136/bmjopen-2019-029878
- https://bmjopen.bmj.com/content/bmjopen/9/8/e029878.full.pdf
- OA Status
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- Cited By
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- References
- 38
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W2971159613
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W2971159613Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1136/bmjopen-2019-029878Digital Object Identifier
- Title
-
Geographical variation in rates of surgical treatment for female stress urinary incontinence in England: a national cohort studyWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2019Year of publication
- Publication date
-
2019-08-01Full publication date if available
- Authors
-
Jil Billy Mamza, Rebecca Geary, Dina El‐Hamamsy, David Cromwell, Jonathan Duckett, Ash Monga, Philip Toozs‐Hobson, Tahir Mahmood, Andrew Wilson, Douglas G. Tincello, Jan van der Meulen, Ipek Gurol‐UrganciList of authors in order
- Landing page
-
https://doi.org/10.1136/bmjopen-2019-029878Publisher landing page
- PDF URL
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https://bmjopen.bmj.com/content/bmjopen/9/8/e029878.full.pdfDirect link to full text PDF
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-
YesWhether a free full text is available
- OA status
-
goldOpen access status per OpenAlex
- OA URL
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https://bmjopen.bmj.com/content/bmjopen/9/8/e029878.full.pdfDirect OA link when available
- Concepts
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Medicine, Urinary incontinence, Cohort, Epidemiology, Cohort study, Demography, Gynecology, Gerontology, Urology, Internal medicine, SociologyTop concepts (fields/topics) attached by OpenAlex
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-
8Total citation count in OpenAlex
- Citations by year (recent)
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2025: 1, 2024: 1, 2022: 1, 2021: 2, 2020: 2Per-year citation counts (last 5 years)
- References (count)
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38Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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