Year: 2018
Type: article
Study design: Observational Study
Abstract: You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Pelvic Prolapse1 Apr 2018MP33-05 ROLE OF HYSTERECTOMY AT THE TIME OF NATIVE PELVIC ORGAN PROLAPSE (POP) REPAIR Bilal Chughtai, Dominique Thomas, Jialin Mao, Tirsit Asfaw, Jennifer Anger, and Art Sedrakyan Bilal ChughtaiBilal Chughtai More articles by this author , Dominique ThomasDominique Thomas More articles by this author , Jialin MaoJialin Mao More articles by this author , Tirsit AsfawTirsit Asfaw More articles by this author , Jennifer AngerJennifer Anger More articles by this author , and Art SedrakyanArt Sedrakyan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1076AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Conventional wisdom is that preserving the uterus may increase the risk of recurrent prolapse due to the inability to adequately support the pelvic floor; hence, hysterectomy is often performed at the time of pelvic organ prolapse (POP) surgery. We sought to evaluate contemporary practices of uterine-preservation versus concomitant hysterectomy at the time of POP repair to determine the outcomes after POP surgery. METHODS This was an observational cohort study of inpatient and ambulatory surgery settings in New York State. Women younger than 55 without prior hysterectomies who underwent POP repair between 2009 and 2014. All POP repairs included apical support in efforts to equate grade of prolapse. Patients who underwent concomitant hysterectomy at time of POP surgery were compared to those who had uterine-preserving surgery. 90-day safety events and re-intervention, urinary retention and pain within one year and three years following initial procedure were determined. RESULTS There were 1564 (71.3%) patients who underwent concurrent hysterectomy at the time of POP surgery, while 629(28.7%) had uterine-preserving surgery. No differences were found in re-interventions and pain within one year or three years after POP repair. Over the study period, we observed increased utilization of concurrent hysterectomy of 46.4% in the most recent study year (P=0.02). Patients undergoing hysterectomy at time of POP surgery were more likely to have procedure performed in an inpatient setting than patients receiving uterine-preserving surgery (80.2% vs 41.2%). After propensity score matching, we found that patients in the concurrent hysterectomy group had more surgical complications and more expensive charges (median charges: $15,013 vs $13,251). CONCLUSIONS To our knowledge this is the first major population cohort study addressing the comparative effectiveness of hysterectomy versus uterine-preservation in POP surgery. Concurrent hysterectomy was more expensive, and had more surgical complications within 90 days of initial procedure when compared to uterine-preserving approach. Long-term outcomes were not compromised and did not lead to earlier reintervention when preserving the uterus. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e429-e430 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Bilal Chughtai More articles by this author Dominique Thomas More articles by this author Jialin Mao More articles by this author Tirsit Asfaw More articles by this author Jennifer Anger More articles by this author Art Sedrakyan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
Source: The Journal of Urology
Language: English
Subfield: Rheumatology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2795905514