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Perioperative outcomes of laparoscopic sacrocolpopexy with and without hysterectomy: a secondary analysis of the National Surgical Quality Improvement Program Database

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Abstract

Introduction and hypothesis

The objective was to compare 30-day perioperative complications in women undergoing minimally invasive sacrocolpopexy with and without a concomitant hysterectomy.

Methods

Using the American College of Surgeons National Surgical Quality Improvement Program database, we identified women undergoing minimally invasive sacrocolpopexy between 2014 and 2018. Women were then stratified into two groups: sacrocolpopexy only and sacrocolpopexy + hysterectomy. The primary outcome was the occurrence of any 30-day postoperative complication. Group comparisons were performed using Student’s t test, Mann–Whitney U test, and Chi-squared test. Multivariate logistic regression was used to identify independent factors associated with the occurrence of any complication.

Results

A total of 8,553 women underwent laparoscopic sacrocolpopexy, 5,123 (59.9%) of whom had a concomitant hysterectomy. Median operative time was longer in women who had sacrocolpopexy + hysterectomy compared with sacrocolpopexy alone (185 [129–241] versus 172 [130–224] min, p < 0.001). The rate of any 30-day postoperative complication did not differ between groups (sacrocolpopexy + hysterectomy 5.5% versus sacrocolpopexy alone 5.8%, p = 0.34). Likewise, organ space, deep, and superficial surgical site infections did not differ between groups. There was also no difference in reoperation or readmission rates between groups. On multivariate logistic regression, sacrocolpopexy + hysterectomy were not associated with increased odds of 30-day postoperative complications relative to women who underwent sacrocolpopexy alone.

Conclusions

Complication rates during the first 30 days after minimally invasive sacrocolpopexy are low and concomitant hysterectomy is not associated with increased risks of 30-day complications after surgery.

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Author information

Authors and Affiliations

  1. Division of Female Pelvic Medicine and Reconstructive Surgery, Northwestern University, Chicago, IL, USA

    Oluwateniola Brown, Tsung Mou, Deepanjana Das, Sarah Collins, Kimberly Kenton & C. Emi Bretschneider

Authors
  1. Oluwateniola Brown
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  2. Tsung Mou
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  3. Deepanjana Das
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  4. Sarah Collins
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  5. Kimberly Kenton
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  6. C. Emi Bretschneider
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Contributions

O. Brown: project development, manuscript writing/editing; T. Mou: manuscript writing/editing; D. Das: manuscript writing/editing; S. Collins: manuscript writing/editing; K. Kenton: manuscript writing/editing; C.E. Bretschneider: project development, data analysis, manuscript writing/editing.

Corresponding author

Correspondence to Oluwateniola Brown.

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Conflicts of interest

Dr. Kimberly Kenton was on the strategic advisory board for Boston Scientific and Drs. Kenton and Collins are expert witnesses for Ethicon. All other authors have no conflicts of interest.

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Appendix

Appendix

Procedure

Current Procedure Terminology code

Total laparoscopic hysterectomy

58570

58571 (with adnexal surgery)

58572

58573 (with adnexal surgery)

Laparoscopic-assisted vaginal hysterectomy

58500

58552 (with adnexal surgery)

58553

58554 (with adnexal surgery)

Laparoscopic supracervical hysterectomy

58541

58542 (with adnexal surgery)

58543

58544 (with adnexal surgery)

Midurethral sling

57288

Appendectomy

44950–44960, 44979

Cholecystectomy

47562, 47563, 47600

Partial and total colectomy

44140–44147, 44160, 44150, 44151, 44155, 44156, 44157, 44158

Enterectomy

44120, 44121, 44125, 44202–44208, 44213

Reason for readmission

n (%)

C. difficile

3 (0.02)

Myocardial infarction

2 (0.02)

Deep incisional SSI

7 (0.1)

Organ/space SSI

37 (0.4)

Superficial incisional SSI

4 (0.01)

Pneumonia

5 (0.1)

Progressive renal insufficiency

1 (0.01)

Pulmonary embolism

7 (0.1)

Sepsis

11 (0.1)

Septic shock

3 (0.04)

Urinary tract infection

12 (0.1)

Deep vein thrombosis

1 (0.01)

Wound disruption

3 (0.02)

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Brown, O., Mou, T., Das, D. et al. Perioperative outcomes of laparoscopic sacrocolpopexy with and without hysterectomy: a secondary analysis of the National Surgical Quality Improvement Program Database. Int Urogynecol J 33, 1889–1895 (2022). https://doi.org/10.1007/s00192-021-04675-4

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  • DOI: https://doi.org/10.1007/s00192-021-04675-4

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