LAUSR

Study Objective To analyze patient and hospital characteristics, stratified by race, among women undergoing minimally invasive and abdominal myomectomies. Design Data was abstracted from the 2010-2014 National Inpatient Sample of women ages 18-50 years undergoing myomectomy for fibroids. We used a multivariate logistic regression to analyze temporal trends in minimally-invasive (laparoscopic and robotic) by patient factors (age, insurance, and income subgroups) and hospital factors (teaching status, for-profit status, size) and stratified by race (White, Black, Hispanic). Setting United States. Patients or Participants 124,880 women ages 18-50 years undergoing inpatient myomectomy for fibroids. Interventions N/A Measurements and Main Results Of the 124,880 women undergoing myomectomy for fibroids, 7% underwent minimally invasive myomectomy (MIM) and 93% underwent abdominal myomectomy. Black women had a total of 55,960 myomectomies performed of which 3,360 (6.0%) were MIM. Black women had lower odds of undergoing MIM at teaching hospitals [OR.79 95%CI.64-.96] and in the highest income bracket [OR.69 95%CI.54-.89]. White women had a total of 39,560 myomectomies performed of which 4,870 (12.3%) were MIM. White women had lower odds of having MIM with private insurance [OR.75 95%CI.60-.93], highest income bracket [OR.71 95%CI.55-.92], at large hospitals [OR.822 95%CI.69-.97], or at teaching hospitals [OR.66 95%CI.56-.79]. Hispanic women had a total of 15,930 myomectomies performed of which 1,140 (7.2%) were MIM. Hispanic women had lower odds of undergoing MIM at for-profit hospitals [OR.62 95%CI.39-.97]. Across all races, women ages 41-50 were more likely to have MIM [White OR 6.5 95%CI 4.73- 8.96, Black OR 2.6 95%CI 1.98-3.44, Hispanic OR 3.73 95%CI 2.28-6.08]. Conclusion Racial disparities exist with access to MIM. Black women undergo the majority of myomectomies, but only 6% are minimally invasive compared to white women (12.3%).