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

Arch Gynecol Obstet. 2018 Aug;298(2):353-361. doi: 10.1007/s00404-018-4818-1. Epub 2018 Jun 21.

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.

Keywords: Pelvic organ prolapse; Perioperative adverse event; Perioperative complication; Sacropexy.

MeSH terms

  • Aged
  • Comorbidity
  • Female
  • Humans
  • Intraoperative Complications / epidemiology*
  • Intraoperative Complications / prevention & control
  • Middle Aged
  • Operative Time
  • Pelvic Organ Prolapse / surgery*
  • Retrospective Studies
  • Risk Factors