Racial Disparities in the Follow-up of Pelvic Organ Prolapse

TOPLINE: 

Emergency department (ED) visits for previously undiagnosed pelvic organ prolapse (POP) revealed significant racial disparities in follow-up care, with non-Hispanic Black women experiencing the lowest rates at 20.7% within 3 months.

METHODOLOGY:

• Researchers conducted a retrospective cross-sectional study at three EDs of an urban academic medical system and single tertiary referral center between January 2016 and September 2022.
• The analysis included 56 female patients (mean age, 61.2 years) with a new diagnosis of POP as per the International Classification of Diseases, Tenth Revision (ICD-10).
• Most patients identified as non-Hispanic Black (51.8%) or Hispanic or Latino (25.0%). Overall, 57.1% of the patients were publicly insured.
• Data on demographics, chief complaints, presenting symptoms, interventions performed, specialist referrals, and follow-up with urogynecology or gynecology within 3 months of discharge from the ED were obtained from the patients’ medical charts.

TAKEAWAY:

• The most common chief complaint was vaginal bulge (42.9%), followed by pelvic pain (28.6%); additional symptoms included urinary symptoms (55.4%) and pelvic pain (44.6%).
• Only 42.8% of patients underwent a 3-month follow-up post-ED discharge.
• Race was significantly associated with follow-up rates (P = .03). Non-Hispanic Black women experienced the lowest 3-month follow-up rates (20.7%).

IN PRACTICE:

“The results of our analysis should help guide resource allocation and drive provider education for this underappreciated condition in a population historically marginalized within healthcare. Further study is imperative to understand barriers leading to ED utilization for undiagnosed POP and to develop ED-based interventions improving timely outpatient care,” the authors wrote.

SOURCE:

The study was led by Angela A. Rutkowski, BS, Rush Medical College of Rush University, Chicago. It was published online on January 22, 2025, in The American Journal of Emergency Medicine.

LIMITATIONS:

The reliance on ICD-10 codes for case detection may have led to underrepresentation of the true disease burden of undiagnosed POP. The study only identified patients who underwent follow-up through the same health system, potentially underestimating actual follow-up rates. Additionally, information about primary care providers was not routinely recorded during ED visits, hampering the determination of the proportion of patients who had providers within vs outside the health system.

DISCLOSURES:

The study received no funding. The authors reported no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.