Perioperative complications of surgery for genital prolapse: does concomitant anti-incontinence surgery increase complications?
OBJECTIVE
To establish whether the short-term risks of prolapse surgery are increased by a concomitant anti-incontinence procedure.


METHODS
Using data from the past 4 years of the National Hospital Discharge Survey, we identified women admitted for surgery for pelvic organ prolapse (specifically, suspension of the vagina or obliteration of the cul-de-sac, with or without concomitant hysterectomy or vaginal repairs). We identified women diagnosed with complications (including infections, bleeding complications, surgical injuries, pulmonary complications, and cardiovascular complications). We used multiple logistic regression analysis to compare women with and without complications with respect to concurrent continence procedures, controlling for demographic characteristics, concurrent procedures, and medical comorbidity (using the Charlson index).


RESULTS
Of the 1931 women who underwent prolapse surgery, concomitant anti-incontinence procedures were performed in 514 (26.6%). Complications were reported in 288 patients (14.9%) and were associated with medical comorbidity (odds ratio 11.2) and concomitant hysterectomy (odds ratio 1.5). Concomitant surgery for incontinence was not associated with an increased risk of complications.


CONCLUSIONS
These data suggest that medical comorbidity is strongly associated with complications after surgery for pelvic organ prolapse. A concomitant anti-incontinence procedure did not significantly increase the immediate morbidity of prolapse surgery.
Handa
Victoria L
VL
Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland 21224-2780, USA. vhanda1@jhmi.edu
Harvey
Lynn
L
Cundiff
Geoffrey W
GW
Kjerulff
Kristen H
KH
D000368:Aged; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012307:Risk Factors; D014550:Urinary Incontinence, Stress / Q000150:complications* / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000009:adverse effects; D014596:Uterine Prolapse / Q000150:complications* / Q000601:surgery*