(Poster 172) Disparities in Initial Evaluation to Pelvic Organ and Rectal Prolapse Surgery

Objectives: Language disparities have been identified as a barrier to accessing pelvic organ prolapse (POP) surgery. Understanding the influence of language is crucial for improving the provision of care to non-English speaking patients. What remains unknown is the presence of language disparities in patients undergoing concomitant surgical intervention for pelvic organ prolapse and rectal prolapse. This study aims to investigate the time interval between initial Urogynecologic evaluation and combined surgical intervention by Urogynecology and Colorectal Surgery by comparing English-speaking and non-English-speaking patients.

Methods: A retrospective chart review study of 148 women was conducted. Patients were identified using a Research Patient Data Registry (RPDR). Patients who were 18 years and older, diagnosed with bothersome Stage II-IV pelvic organ prolapse and rectal prolapse and underwent surgical repair within a single healthcare system between January 2019-January 2024 were eligible to participate in the study. Patients were excluded if their initial urogynecology evaluation note was inaccessible or if they were under 18. Statistical analysis was performed using Stata/IC 15 to assess the time between initial urogynecology consultation and surgical intervention, examining its association with the patient's primary language. Secondary outcomes included the observation of disparities in the type of interpreter used, insurance type, and race/ethnicity.

Results: Among patients undergoing both POP surgery and rectal prolapse repair (N=148), non-English-speaking patients (N=5) experienced a longer median time to surgical intervention (245 days) compared to English-speaking patients (N=143, 122 days, p=0.26), though not statistically significant. There was also no significant difference in time to surgery found when comparing patients by race/ethnicity and insurance type.

Conclusions: With non-English speakers experiencing longer delays, this study suggests a language disparity in the time to surgical intervention between English and non-English-speaking patients undergoing combined pelvic organ prolapse and rectal prolapse surgery. The low number of Non-English speaking patients (N=5) included in the study likely contributes to the statistically insignificant findings. Similarly, a sub analysis comparing white vs. non-white patients (N=10) did not show a statistically significant difference in time to surgery. The study invites further investigation to identify the contributing factors to the small number of non-English-speaking or non-white patients undergoing POP-RP surgery, which may require institutional review of the skewed patient evaluation process. Future studies with a larger sample size of non-English speaking patients will improve the understanding of disparities experienced by patients seeking multidisciplinary care for pelvic organ prolapse and rectal prolapse.