National trends and costs of surgical treatment for female fecal incontinence

OBJECTIVE: The objective of the study was to describe national trends, hospital charges, and costs of inpatient surgical treatment for female fecal incontinence in the United States. STUDY DESIGN: We used the Nationwide Inpatient Sample from 1998 to 2003 to identify women who underwent surgery for fecal incontinence using International Classification of Diseases, ninth revision-CM coding. We examined national trends in procedures, patient demographics, outcomes, hospital charges, and costs. Multiple linear regression was used to identify variables associated with increased costs. RESULTS: A total of 21,547 women underwent inpatient surgery for fecal incontinence during the study period. This number has remained stable, with 3423 procedures in 1998 and 3509 procedures in 2003. The overall risk of complications was 15.4% and the risk of death was 0.02%, which remained stable during the study period. Total charges increased from $34 million in 1998 to $57.5 million in 2003, translating to a total cost of $24.5 million in 2003. Variables associated with increased costs included number of procedures per admission, length of stay, patient age, and race (P < .05). CONCLUSION: The number of women undergoing surgical treatment for fecal incontinence is stable but has a significant economic impact on the health care system.