PMID- 33476105
OWN - NLM
STAT- MEDLINE
DCOM- 20220201
LR  - 20220201
IS  - 2154-4212 (Electronic)
IS  - 2151-8378 (Linking)
VI  - 27
IP  - 10
DP  - 2021 Oct 1
TI  - Perioperative Adverse Events in Women Undergoing Vaginal Prolapse Repair With 
      Uterine Preservation Versus Concurrent Hysterectomy: A Matched Cohort Study.
PG  - 621-626
LID - 10.1097/SPV.0000000000001011 [doi]
AB  - OBJECTIVE: The objective of this study is to compare the incidence of 
      perioperative adverse events (AEs) in women undergoing vaginal prolapse repair 
      with uterine preservation (hysteropexy) versus concurrent hysterectomy. METHODS: 
      This was a retrospective matched cohort study between 2012 and 2019. Patients who 
      received a sacrospinous or uterosacral hysteropexy or colpopexy with hysterectomy 
      were matched by surgeon, surgical year, and age. The electronic medical record 
      was queried for demographic and perioperative data. Strict definitions were used 
      for all clinically relevant AEs. RESULTS: One hundred and thirty hysteropexy (89 
      sacrospinous, 41 uterosacral) patients were matched to 260 concurrent 
      hysterectomy (6 sacrospinous, 253 uterosacral, 1 both) patients. Mean age and 
      body mass index were 58 years (+/-13 years) and 27.9 kg/m2 (+/-6 kg/m2). Compared 
      with hysteropexy, cases with hysterectomy were longer, had higher blood loss, and 
      a longer hospital stay. The overall incidence of AEs was 29.0% for concurrent 
      hysterectomy versus 10.5% in hysteropexy cases (P = 0.02); on logistic 
      regression, concurrent hysterectomy remained a statistically significant 
      predictor of AEs, with an adjusted odds ratio of 4.03 (95% confidence interval, 
      1.48-11.01). There was no difference in Dindo grade 3 complications between 
      concurrent hysterectomy and hysteropexy procedures (0.8% vs 1.3%, P = 0.12). In a 
      subanalysis examining the 2 hysteropexy types, there were no significant 
      differences in AEs. CONCLUSIONS: The overall incidence of serious AEs is low in 
      women with uterovaginal prolapse undergoing vaginal native tissue repair with or 
      without hysterectomy. Vaginal hysteropexy is associated with lower odds of 
      experiencing AEs, shorter operating times, a shorter length of stay, and less 
      blood loss.
CI  - Copyright (c) 2021 American Urogynecologic Society. All rights reserved.
FAU - Yuan, Angela S
AU  - Yuan AS
AD  - From the Obstetrics, Gynecology and Women's Health Institute at the Cleveland 
      Clinic, Center for Urogynecology and Pelvic Reconstructive Surgery, Cleveland 
      Clinic, Cleveland, OH.
FAU - Chang, Olivia H
AU  - Chang OH
FAU - Ferrando, Cecile A
AU  - Ferrando CA
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Female Pelvic Med Reconstr Surg
JT  - Female pelvic medicine & reconstructive surgery
JID - 101528690
SB  - IM
MH  - Cohort Studies
MH  - Female
MH  - Gynecologic Surgical Procedures
MH  - Humans
MH  - Hysterectomy/adverse effects
MH  - Hysterectomy, Vaginal/adverse effects
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - *Uterine Prolapse/surgery
COIS- The authors have declared they have no conflicts of interest.
EDAT- 2021/01/22 06:00
MHDA- 2022/02/02 06:00
CRDT- 2021/01/21 13:18
PHST- 2021/01/22 06:00 [pubmed]
PHST- 2022/02/02 06:00 [medline]
PHST- 2021/01/21 13:18 [entrez]
AID - 01436319-202110000-00006 [pii]
AID - 10.1097/SPV.0000000000001011 [doi]
PST - ppublish
SO  - Female Pelvic Med Reconstr Surg. 2021 Oct 1;27(10):621-626. doi: 
      10.1097/SPV.0000000000001011.