Perioperative morbi-mortality after pelvic organ prolapse surgery in a large French national database from gynecologist surgeons.

Affiliation

Department of Obstetrics and Gynecology, Carémeau University Hospital, Nîmes, France. Electronic address: [Email]

Abstract

OBJECTIVE : To assess morbidity and mortality following pelvic organ prolapse surgery in France, irrespective of the surgical technique, using a broad national database.
METHODS : This descriptive multicenter retrospective study was conducted using a database populated via an application run by a professional association.
RESULTS : 286 gynecologists contributed data to the database. Of the 4322 surgeries analyzed, an abdominal approach was used in 975 of cases (22.5%), a vaginal approach in 3277 (75.9%), and a combined approach in 68 (1.6%). After one year, abdominal surgery was associated with higher rates of de novo urinary incontinence, constipation, and intestinal obstruction, whereas vaginal surgery was associated with higher rates of urinary retention, hematoma, de novo chronic pain, and vaginal mesh extrusion. There was no significant difference between the groups in the incidence of severe complications. After one year, vaginal mesh-augmented cystocele repair was associated with higher rates of de novo urinary incontinence, de novo chronic pain, and reoperation than native tissue repair. Mesh repair was also associated with higher rates of severe complications at one year.
CONCLUSIONS : After pelvic organ prolapse surgery, the perioperative morbidity and mortality associated with transabdominal and transvaginal approaches are similar. However, transvaginal mesh repair is associated with greater perioperative morbidity than transvaginal native tissue repair.

Keywords

Morbidity,Mortality,Pelvic organ prolapse,Sacrocolpopexy,Vaginal surgery,

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