Surgical procedures for female genital prolapse

• There is significant geographical variation in the use of surgery for vaginal and uterine prolapse.
• The total number of operations increased by 12% from 2023 to 2024.
• The proportion of procedures performed as day surgery increased by five percentage points from 2023 to 2024.

During the period 2015 - 2019, the number of procedures remained stable at just over 4 000 per year. In 2020, the number of procedures decreased by approximately 20% compared to the period 2015 - 2019. After the pandemic, the number of procedures increased slightly each year. From 2023 to 2024, there was a larger increase, and in 2024, a total of 4171 procedures were performed. The median age of those undergoing surgery has remained stable at 63 years throughout the period from 2015 to 2024.

The geographical variation has been significant throughout the period from 2015 to 2024. From 2023 to 2024, the rate for residents in the Finnmark catchment area decreased from 4.4 to 3.0 procedures per 1 000 inhabitants. This resulted in less geographical variation in 2024 compared to 2023. The catchment areas of OUS, Diakonhjemmet, Lovisenberg, Akershus, and Vestfold have had low rates throughout the period from 2015 to 2024. The catchment areas of Finnmark, Helgeland, and Fonna have had high rates throughout the period 2015 - 2024.

The extent of treatment in private facilities is very limited.

Nationally, the proportion of procedures performed as day surgery increased from 40.5% in 2023 to 45.6% in 2024. In the catchment areas of Finnmark, Sørlandet, Telemark, OUS, and Diakonhjemmet, less than 10% of operations were performed as day surgery in 2024, while in the catchment areas of St. Olav and Nordland, the corresponding proportion was over 80%. The largest increase was in the Helgeland catchment area, where the proportion increased from 10% in 2023 to 41% in 2024.

The analysis is based on activity data from the Norwegian Patient Register (NPR) for somatic specialist health services. The data includes activity in public hospitals and private hospitals that provide publicly funded services. Data from specialists under public funding contracts are not included, as this treatment is only provided in hospitals.

The sample consists of contact for women aged 16 years or older with a primary or secondary diagnosis of N81 in combination with one or more of the following procedure codes: LEF 00, LEF 03, LEF 10, LEF 13, LEF 16, LEF 20, LEF 23, LEF 34, LEF 40, LEF 41, LEF 50, LEF 51, LEF 53, LEF 96 eller LEF 97. See also Metodebok.no.

The place of treatment is divided into three categories:

• Local public, treated at one of the hospitals in the catchment area
• Other public, treated at a public hospital outside the catchment area
• Private, treated by a private hospital

In order to compare the catchment areas and between years, the rates have been adjusted for gender and age. The adjustment was done using the direct method with the countrys population in 2023 as the reference population.

SKDE is solely responsible for the interpretation and presentation of the data provided by NPR. FHI/NPR is not responsible for analyses or interpretations based on the data.

All of the data used in the charts for this analysis can be downloaded as a CSV file.