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A survey of the complications of vaginal prolapse surgery performed by members of the Society Of Gynecologic Surgeons

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Abstract

This study aimed to examine the frequency and nature of complications of vaginal prolapse surgery performed by members of SGS over a year and to determine the feasibility and the problems associated with prospective, multicentered collaborative data acquisition. A survey form, which included demographics, surgical indications, colpopexy type, concomitant procedures, technique, estimated blood loss (EBL), OR time, and intra/postoperative complications, was distributed to society members. The nature, extent, and solution of the complications were examined. There were 147 members of SGS at the time of the study. Many were reproductive endocrinologists and gynecologic oncologists. Twenty-one (14%) members participated. Three hundred forty-nine (349) completed forms were received: 187 sacrospinous fixations (SSF), 92 colposacropexies (CSP), and 70 high utero sacral suspensions (HUS). There were seven (3.7%) intraoperative complications for SSF, seven (7.6%) for CSP and three (4.3%) for HUS. There were four (2.1%) postoperative complications for SSF, six (6.5%) for CSP and none for HUS (NS). OR time was significantly longer for CSP vs. HUS ( P <.003) and for SSF vs. HUS ( p =.042). The EBL was significantly higher for SSF compared with CSP for the colpopexy procedure ( p =.013) and for entire cases ( p <.003). Analysis showed that all three colpopexies had significant intraoperative and postoperative complications of less than 8%. Intraoperative visceral damage was a concern for all three procedures. With SSF and CSP there was risk of bleeding and with HUS there was a risk of ureteral obstruction. Postoperative CSP complications were bowel obstruction, bleeding or hernia; for SSF neuropathy, and for HUS none. No life-threatening intraoperative or postoperative complications were reported. OR time was significantly shorter for HUS than SSF. The highest EBL was with SSF. Only 14% of the SGS membership responded, despite multiple requests for participation, demonstrating the difficulty of multicenter data gathering.

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Acknowledgments

We would like to individually thank the SGS contributors for taking the time and effort to collect and submit these data: Drs. Terry Grody, et al., Ed Varner et al., Bob Porges, John Spurlock, John Boldt et al., Mark Walters, Maria Paraiso, Anne Weber, James Breen, Peggy Norton, Michael Aronson, Deborah Myers, Jeff Cornella, Javier Magrina, Arnold Friedman, Steve Metz, Dave Chapin, Harold Drutz, and Lester Ballard. Dr. Tony Monteiro contributed to this work during its earlier stages. We are also indebted to Mrs. Allison Howard for all her work in assembling and processing the information.

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Authors and Affiliations

  1. Division of Urogynecology & Reconstructive Pelvic Surgery, UMass Memorial Medical Center, University of Massachusetts Medical School, 119 Belmont Street, Worcester, MA, 01605, USA

    Stephen B. Young

  2. Department of Gynecology, Yale University School of Medicine, New Haven, CT, 06510, USA

    Ernest I. Kohorn

  3. Obstetrics & Gynecology, University of Massachusetts

    Susan Braz-Martin

  4. University of Massachusetts Medical School

    Stephen P. Baker

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  1. Stephen B. Young
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  2. Ernest I. Kohorn
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  3. Susan Braz-Martin
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  4. Stephen P. Baker
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Correspondence to Stephen B. Young.

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Editorial Comment: The report of multicenter prospective collaborative data acquisition of surgical complications, duration, blood loss, etc., is ambitious and interesting, as much for the insights into the methodology of performing this type of research as the results themselves. This represents an important step in the evolution of clinical outcomes work in surgery for pelvic floor disorders. We have long recognized that single-center studies are routinely hampered by sample sizes inadequate to detect clinically or statistically significant differences between outcomes. The lessons learned will facilitate optimal function of data acquisition networks. In doing so, it will enhance our ability to counsel patients accurately on surgical risks. Eventually, more sophisticated and longer-term data may serve to guide selection of surgical procedures based upon large cohorts of patients.

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Young, S.B., Kohorn, E.I., Braz-Martin, S. et al. A survey of the complications of vaginal prolapse surgery performed by members of the Society Of Gynecologic Surgeons. Int Urogynecol J 15, 165–170 (2004). https://doi.org/10.1007/s00192-004-1127-y

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  • DOI: https://doi.org/10.1007/s00192-004-1127-y

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