EP 510 Trends in Obstetric Injury and Management of Faecal Incontinence in Japan: a National Database Study
Aimée Roze Lawton, Gillian Hannah Louise Miller, Yasuko MaedaAbstract
Objectives
The primary aim was to estimate the burden of faecal incontinence (FI) in Japan and to assess trends in incontinence treatment using national databases.
Methods
Data were extracted from the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB), an anonymised national administrative claims database, and from e-Stat, the official Japanese Government Statistics portal, for population size, number of births, and maternal age. Data from the Hospital Report and the Survey of Medical Institutions were used to assess outpatient activity. Data from 2014 to 2023 were analysed.
Results
The population of Japan declined from 125,431,000 to 121,193,394 (3.4% decrease), while the population aged ≥65 years increased from 32,866,000 to 36,018,535 (9.5% increase). The number of births decreased from 1,003,609 in 2014 to 727,288 in 2023 (27.5% decrease; slope −35,385.2; p<0.05). Forceps deliveries increased from 6,160 to 8,686 (41% increase; slope 244.7; p<0.05), and third-degree perineal tears increased from 20,261 to 29,074 (43.5% increase; slope 932.5; p<0.05), with a positive correlation between the two trends (p<0.05). However, the numbers of diagnostic investigations (median 6,710, range 5’865 to 7’709), sphincteroplasty (median 60.5, range 31 to 131), and sacral neuromodulation (median 65, range 30 to 90) procedures remained low throughout the study period.
Conclusions
Despite an ageing population and increasing obstetric injury, utilisation of diagnostic investigations and treatments for faecal incontinence remains low in Japan, suggesting potential barriers to access or under-recognition of disease. Further work is needed to evaluate regional disparities and pathways of care.