Objective To evaluate racial and ethnic differences in knowledge about preventative and curative treatments for pelvic floor disorders (PFD). Methods The is a secondary analysis of responses from 416 community-dwelling women, aged 19-98 years, living in New Haven County, Connecticut, who completed the Prolapse and Incontinence Knowledge Questionnaire. Associations between race/ethnicity (categorized as White, African American, and Other Women of Color [OWOC, combined group of Hispanic, Asian or ‘Other’ women] and knowledge proficiency about modifiable risk factors and treatments for PFD were evaluated. Associations were adjusted for age, marital status, socioeconomic status, education, working in a medical field, and PFD history. Results Compared to White women, African American women were significantly less likely to recognize childbirth as a risk factor for UI and POP, to know that exercises can help control leakage, and to recognize pessaries as a treatment option for POP. OWOC were also significantly less likely to know about risk factors, preventative strategies and curative treatment options for POP and UI; however, these findings may not be generalizable given the heterogeneity and small size of this group. Conclusions Significant racial disparities exist in women's baseline knowledge regarding risk factors and treatment options for POP and UI. Targeted, culturally-sensitive educational interventions are essential to enhancing success in reducing the personal and economic burden of PFD, which have proven negative effects on women's quality of life.

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Objective To describe the association between social isolation and urinary incontinence (UI) and fecal incontinence (FI) in older women. Methods We conducted a secondary database analysis of the National Social Life, Health and Aging Project (NSHAP) for women aged 57 to 85 years old. Our primary outcome was self-report of often feeling isolated. We explored self-report of daily UI and weekly FI. Two logistic regression analyses were performed to assess the association between often feeling isolated and 1) daily UI and 2) weekly fecal incontinence. Results A total of 1,412 women were included in our analysis. Daily UI was reported by 12.5% (177/1,412) of community-dwelling older women. More women with daily UI reported often feeling isolated (6.6%, 95% CI [1.3–11.9] vs. 2.6%, 95% [1.7–3.5], p=.04) compared with women without daily UI. Women with daily UI had 3.0 (95% CI 1.1, 7.6) increased odds of often feeling isolated after adjusting for depressive symptoms, age, race, education, and overall health. Weekly FI was reported by 2.9% (41/1,412) of women. Weekly FI and often feeling isolated were associated on univariable analysis (Crude Odds Ratio(OR) = 4.6 (95% CI 1.4, 15.1). However after adjusting for depressive symptoms, age, race, education, and overall health the association between weekly FI and often feeling isolated was not significant (Adjusted OR=0.65 (95% CI 0.1, 5.3, p=0.65)). Conclusion After adjusting for confounders, daily UI was significantly associated with often feeling isolated. Weekly FI was not found to be associated with often feeling isolated on multivariable logistic regression.

The aims of this study were to estimate the occurrence of postoperative surgical site infections (SSIs) after different routes of hysterectomy and to identify associated risk factors. The investigators conducted a secondary cross-sectional analysis of the 2005Y2009 American College of Surgeons National Surgical Quality Improvement Program (NSQIP) to examine data files of women undergoing hysterectomies. The primary hysterectomy routes compared were laparotomy and the vaginal approach. The main study outcome was the occurrence of 30-day superficial SSI (cellulitis) after hysterectomy; secondary outcomes were the occurrence of deep and organ-space SSI. Logistic regression models were used to examine associations of risk factors after hysterectomy. The final analysis included 13,822 women who had undergone hysterectomy.The occurrence of cellulitis after hysterectomy was 1.6% (221/13,822). Multivariate analysis showed that the following risk factors were associated with 30-day postoperative cellulitis: route of hysterectomy (adjusted odds ratio [aOR], 3.74; 95% confidence interval [CI], 2.26Y6.22 for laparotomy compared with the vaginal approach), operative time greater than 75th percentile (aOR,1.84; 95% CI, 1.40Y2.44), American Society of Anesthesia Class 3 or greater (aOR, 1.79; 95% CI, 1.31Y2.43), morbid obesity (body mass index Q40 kg/m 2 ) (aOR, 2.65; 95% CI, 1.85Y3.80), and diabetes mellitus (aOR, 1.54; 95% CI, 1.06Y2.24). The occurrence of deep and organ-space SSI after hysterectomy was 1.1% (154/13,822).These data show decreased occurrence of superficial SSI after use of the vaginal approach for hysterectomy and reaffirm the role for vaginal hysterectomy as the route of choice for hysterectomy.

Objective Our objective was to estimate the occurrence of surgical site infections (SSI) after hysterectomy and associated risk factors. Study Design We conducted a cross-sectional analysis of the 2005-09 American College of Surgeons National Surgical Quality Improvement Program participant use data files to analyze hysterectomies. Different routes of hysterectomy were compared. The primary outcome was to identify the occurrence of 30-day superficial SSI (cellulitis) after hysterectomy. Secondary outcomes were the occurrence of deep and organ-space SSI after hysterectomy. Logistic regression models were conducted to further explore the associations of risks factors with SSI after hysterectomy. Results A total of 13,822 women were included in our final analysis. The occurrence of postoperative cellulitis after hysterectomy was 1.6% (n= 221). Risk factors associated with cellulitis were route of hysterectomy with an adjusted odds ratio (AOR) of 3.74 (95% CI 2.26-6.22) for laparotomy compared with the vaginal approach, operative time > 75th percentile (AOR = 1.84, 95% CI 1.40-2.44), American Society of Anesthesia Class ≥ 3 (AOR 1.79, 95% CI 1.31-2.43), body mass index ≥ 40kg/m2 (AOR 2.65, 95% CI 1.85-3.80), and diabetes mellitus (AOR 1.54, 95% CI 1.06-2.24) The occurrence of deep and organ-space SSI was 1.1% (n= 154) after hysterectomy. Conclusion Our finding of the decreased occurrence of superficial SSI after vaginal approach for hysterectomy reaffirms the role for vaginal hysterectomy as the route of choice for hysterectomy.