Isabelle Le Teuff1, Majd Labaki1, Pascale Fabbro-Peray2, Philippe Debodinance3, Bernard Jacquetin4, Jean Marty5, Vincent Letouzey1, Georges Eglin6, Renaud de Tayrac7. 1. Department of Obstetrics and Gynecology, Carémeau University Hospital, Nîmes, France. 2. Department of Biostatistics, Epidemiology, Public Health and Medical Information (BESPIM), Nîmes University Hospital, Nîmes, France. 3. Department of Obstetrics and Gynecology, Dunkerque Hospital, France. 4. Department of Obstetrics and Gynecology, Estaing University Hospital, Clermont-Ferrand, France. 5. Toulouse, France. 6. Department of Obstetrics and Gynecology, Clinique Champeau, Beziers, France. 7. Department of Obstetrics and Gynecology, Carémeau University Hospital, Nîmes, France. Electronic address: renaud.detayrac@chu-nimes.fr.
Abstract
OBJECTIVE: To assess morbidity and mortality following pelvic organ prolapse surgery in France, irrespective of the surgical technique, using a broad national database. MATERIALS AND 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. CONCLUSION: 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.
OBJECTIVE: To assess morbidity and mortality following pelvic organ prolapse surgery in France, irrespective of the surgical technique, using a broad national database. MATERIALS AND 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. CONCLUSION: 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.
Authors: C Emi Bretschneider; Charles D Scales; Oyomoare Osazuwa-Peters; David Sheyn; Vivian Sung Journal: Int Urogynecol J Date: 2022-06-04 Impact factor: 1.932