Top

Published in:

01-08-2018 | General Gynecology

Perioperative adverse events associated with pelvic organ prolapse repair by nerve-preserving sacropexy: an analysis of 768 cases over a 10-year period

Authors: Tilemachos Kavvadias, Birgitt Schoenfisch, Markus Huebner, Sara Y. Brucker, Diethelm Wallwiener, Christl Reisenauer

Published in: Archives of Gynecology and Obstetrics | Issue 2/2018

Abstract

Objective

To report the perioperative adverse events associated with nerve-preserving sacropexy for pelvic organ prolapse (POP) repair and to identify risk factors that could predict possible adverse events.

Materials and methods

A total of 768 women who underwent sacropexy for POP repair performed by one surgeon using the same technique, beyond the learning curve, over a 10-year period, between January 1st 2007 and December 31st 2016.

Methods

The medical records of 768 women were reviewed for age, body mass index (BMI), tobacco use, previous surgeries (for POP and incontinence, abdominal surgeries in general), operating time, duration of hospitalization and perioperative events at time of surgery and 6 weeks postoperatively. Additionally, the complications were classified according to the Clavien–Dindo grading system and the Charlson Age Comorbidity Index (CACI) was evaluated for the patients.

Results

Between January 1st 2007 and December 31st 2016, 768 patients underwent sacropexy for POP. 27 (3.5%) adverse events occurred intra- and post-operative within 6 weeks after surgery. In univariate and multivariate analyses, only comorbidity and concomitant posterior colporrhaphy are significantly associated with complications.

Conclusions

Surgeon’s experience and a standardized technique minimize the risk of perioperative adverse events. The data on complications we found can be used to guide effective consent.

Haylen BT, Maher CF, Barber MD, Camargo S, Dandolu V, Digesu A, Goldman HB, Huser M, Milani AL, Moran PA, Schaer GN, Withagen MI (2016) International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic organ prolapse (POP). Int Urogynecol J 27:655–684. https://doi.org/10.1007/s00192-016-3003-y CrossRefPubMed

Wu JM, Matthews CA, Conover MM, Pate V, Jonsson Funk M (2014) Lifetime risk of stress urinary incontinence or pelvic organ prolapse surgery. Obstet Gynecol 123:1201–1206. https://doi.org/10.1097/AOG.0000000000000286 CrossRefPubMedPubMedCentral

National Cancer Institute. Surveillance Research. Lifetime risk tables. http://seer.cancer.gov/csr/1975_2010/results_merged/topic_lifetime_risk.pdf. Accessed 10 Dec 2013

Maher C, Feiner B, Baessler K, Christmann-Schmid C, Haya N, Brown J (2016) Surgery for women with apical vaginal prolapse. Cochrane Datab Syst Rev. https://doi.org/10.1002/14651858.cd012376 CrossRef

Claerhout F, De Ridder D, Roovers JP, Rommens H, Spelzini F, Vandenbroucke V, Coremans G, Deprest J (2009) Medium-term anatomic and functional results of laparoscopic sacrocolpopexy beyond the learning curve. Eur Urol 55:1459–1467. https://doi.org/10.1016/j.eururo.2008.12.008 CrossRefPubMed

Anand M, Woelk JL, Weaver AL, Trabuco EC, Klingele CJ, Gebhart JB (2014) Perioperative complications of robotic sacrocolpopexy for post-hysterectomy vaginal vault prolapse. Int Urogynecol J 25:1193–1200. https://doi.org/10.1007/s00192-014-2379-9 CrossRefPubMed

Dindo D, Demartines N, Clavien PA (2004) A new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213CrossRefPubMedPubMedCentral

Charlson M, Szatrowski TP, Peterson J, Gold J (1994) Validation of a combined comorbidity index. J Clin Epidemiol 47:1245–1251CrossRefPubMed

Shiozawa T, Huebner M, Hirt B, Wallwiener D, Reisenauer C (2010) Nerve-preserving sacrocolpopexy: anatomical study and surgical approach. Eur J Obstet Gynecol Reprod Biol 152:103–107. https://doi.org/10.1016/j.ejogrb.2010.05.009 CrossRefPubMed

10.

Unger CA, Paraiso MF, Jelovsek JE, Barber MD, Ridgeway B (2014) Perioperative adverse events after minimally invasive abdominal sacrocolpopexy. Am J Obstet Gynecol 211:547.e1–e8. https://doi.org/10.1016/j.ajog.2014.07.054 CrossRef

11.

Bradley CS, Kenton KS, Richter HE, Gao X, Zyczynski HM, Weber AM, Nygaard IE (2008) Pelvic floor disorders network. obesity and outcomes after sacrocolpopexy. Am J Obstet Gynecol 199:690e1–e8. https://doi.org/10.1016/j.ajog.2008.07.030 CrossRef

12.

Turner L, Lavelle E, Lowder J, Shepherd JP (2016) The impact of obesity on intraoperative complications and prolapse recurrence after minimally invasive sacrocolpopexy. Female Pelvic Med Reconstr Surg 22:317–323. https://doi.org/10.1097/SPV.0000000000000278 CrossRefPubMed

13.

Centers for Disease Control and Prevention. Defining Overweight and Obesity. http://www.cdc.gov/obesity/adult/defining.html. Accessed 20 Apr 2015

14.

Sung V, Weitzen S, Sokol ER, Rardin CR, Meyers DL (2006) Effect of patient age on increasing morbidity and mortality following urogynecologic surgery. Am J Obstet Gynecol 194:1411–1417CrossRefPubMed

15.

Richter HE, Goode PS, Kenton K, Brown MB, Burgio KL, Kreder K, Moalli P, Wright EJ, Weber AM, Network Pelvic Floor Disorders (2007) The effect of age on short-term outcomes after abdominal surgery for pelvic organ prolapse. J Am Geriatr Soc 55:857–863CrossRefPubMed

16.

Campbell P, Cloney L, Jha S (2016) Abdominal versus laparoscopic sacrocolpopexy: a systematic review and meta-analysis. Obstet Gynecol Surv 71:435–442. https://doi.org/10.1097/OGX.0000000000000335 CrossRefPubMed

17.

Coolen AWM, van Oudheusden AMJ, Mol BWJ, van Eijndhoven HWF, Roovers JWR, Bongers MY (2017) Laparoscopic sacrocolpopexy compared with open abdominal sacrocolpopexy for vault prolapse repair: a randomised controlled trial. Int Urogynecol J 28:1469–1479. https://doi.org/10.1007/s00192-017-3296-5 CrossRefPubMedPubMedCentral

18.

Yamamoto M, Minikel L, Zaritsky E (2011) Laparoscopic 5-mm trocar site herniation and literature review. JSLS 15:122–126. https://doi.org/10.4293/108680811X13022985131697 CrossRefPubMedPubMedCentral

19.

Pereira N, Hutchinson AP, Irani M, Chung ER, Lekovich JP, Chung PH, Zarnegar R, Rosenwaks Z (2016) 5-millimeter trocar-site hernias after laparoscopy requiring surgical repair. J Minim Invasive Gynecol 23:505–511. https://doi.org/10.1016/j.jmig.2016.03.001 CrossRefPubMed

20.

Siddiqui NY, Grimes CL, Casiano ER, Abed HT, Jeppson PC, Olivera CK, Sanses TV, Steinberg AC, South MM, Balk EM, Sung VW, Society of Gynecologic Surgeons Systematic Review Group (2015) Mesh sacrocolpopexy compared with native tissue vaginal repair: a systematic review and meta-analysis. Obstet Gynecol 125:44–55. https://doi.org/10.1097/aog.0000000000000570 CrossRefPubMedPubMedCentral

21.

Madsen LD, Nüssler E, Kesmodel US, Greisen S, Bek KM, Glavind-Kristensen M (2017) Native-tissue repair of isolated primary rectocele compared with nonabsorbable mesh: patient-reported outcomes. Int Urogynecol J 28:49–57. https://doi.org/10.1007/s00192-016-3072-y CrossRefPubMed

Title: Perioperative adverse events associated with pelvic organ prolapse repair by nerve-preserving sacropexy: an analysis of 768 cases over a 10-year period
Authors: Tilemachos Kavvadias
Birgitt Schoenfisch
Markus Huebner
Sara Y. Brucker
Diethelm Wallwiener
Christl Reisenauer
Publication date: 01-08-2018
Publisher: Springer Berlin Heidelberg
Published in: Archives of Gynecology and Obstetrics / Issue 2/2018
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-018-4818-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Perioperative adverse events associated with pelvic organ prolapse repair by nerve-preserving sacropexy: an analysis of 768 cases over a 10-year period

Abstract

Objective

Materials and methods

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Materials and methods

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 2/2018

Efficacy of GnRH agonist trigger in women having history of follicular–endometrial asynchrony with clomiphene/IUI cycles in unexplained infertility

Complicated primary cesarean delivery increases the risk for uterine rupture at subsequent trial of labor after cesarean

Study on the cephalopelvic relationship with cephalic presentation in nulliparous full-term Chinese pregnant women by MRI with three-dimensional reconstruction

Conservative management of endometrial cancer: a survey amongst European clinicians

Pressurized intraperitoneal aerosol chemotherapy (PIPAC) for peritoneal carcinomatosis: systematic review of clinical and experimental evidence with special emphasis on ovarian cancer

Prenatal diagnosis of Wolf–Hirschhorn syndrome: from ultrasound findings, diagnostic technology to genetic counseling