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The Racial Distribution Of Female Pelvic Floor Disorders In An Equal Access Health Care System
Christine L Gray Sears1, James R Jezior1, Sandra L Hernandez*1, Johnnie Wright*1, Sohail A Siddique*1, Todd S Albright*1, Rebecca Chason*2, John R Fischer*1
1National Capitol Consortium, Walter Reed Army Medical Center, Washington, DC;2National Capitol Consortium, Washington, DC
Introduction: Female pelvic floor disorders in the United States have been reported to vary by race. Our hypothesis was that in an equal access health care system these racial differences would not exist.
Methods: A retrospective electronic medical record review was performed for patients evaluated for pelvic floor disorders in a practice with equal healthcare access for eligible patients from Jan 1 2004- Dec 31 2004. 720 individual patients were identified; 55 (7.6%) did not have race clearly identified. Primary ICD-9 diagnoses were reviewed to evaluate the distribution of pelvic floor disorders.
Results: The racial-ethnic distribution was as follows: 497 (69%) white, 134 (18.6%) black, 19(2.6%) Hispanic, and 15 (2.1%) Asian, and 55 (7.6%) unidentified or “other”. Primary diagnoses were as follows: 246 (34.2%) pelvic organ prolapse, 142 (19.7%) stress incontinence, 78 (10.8%) urge incontinence, 67 (9.3%) pain disorders, 35 (4.9%) unspecified incontinence, 21 (2.9%) bladder overactivity, 18 (2.5%) fecal incontinence, 13(1.8%) urinary retention and 100 (13.9%) unidentified or other. Blacks were younger than whites (52.9 vs. 56.5 years p=0.022). There was no difference when all diagnoses were examined. However in patients with specified incontinence, more blacks had urge incontinence (51%) and more whites had stress incontinence (66%) (p=0.037 Chi-square)
Conclusions: There is a similar distribution of pelvic disorders in blacks and whites presenting for specialty care in an equal access health care system. There are differences in specific types of incontinence, however, with more black women having urge incontinence and more white women having stress incontinence.
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