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The effect of concomitant hysterectomy on complications following pelvic organ prolapse surgery

  • Urogynecology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Pelvic organ prolapse (POP) surgery is performed with and without concomitant hysterectomy depending on a variety of factors. The objective was to compare 30-day major complications following POP surgery with and without concomitant hysterectomy.

Methods

This was a retrospective cohort study using the National Surgical Quality Improvement Program (NSQIP) multicenter database to compare 30-day complications using Current Procedural Terminology (CPT) codes for POP with or without concomitant hysterectomy. Patients were grouped by procedure: Vaginal prolapse repair (VAGINAL), minimally invasive sacrocolpopexy (MISC), and open abdominal sacrocolpopexy (OASC). 30-day postoperative complications and other relevant data were evaluated in patients who underwent concomitant hysterectomy compared to those who did not. Multivariable logistic regression models assessed the association of concomitant hysterectomy on 30-day major complications stratified by surgical approach.

Results

60,201 women undergoing POP surgery comprised our cohort. Within 30 days of surgery, there were 1722 major complications in 1432 patients (2.4%). Prolapse surgery alone had a significantly lower overall complication rate than with concomitant hysterectomy (1.95% vs 2.81%; p < .001). Multivariable analysis revealed odds of complications following POP surgery was higher among women who underwent concomitant hysterectomy compared to those who did not have hysterectomy in VAGINAL (OR 1.53, 95% CI 1.36–1.72), OASC (OR 2.70, 95% CI 1.69–4.33), and overall (OR 1.46, 95% CI 1.31–1.62), but not in MISC (OR 0.99, 95% CI 0.67–1.46.)

Conclusion

Concomitant hysterectomy at the time of pelvic organ prolapse (POP) surgery increases the risk of 30-day postoperative complications in comparison to prolapse surgery alone in our overall cohort.

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Data availability

The ACS NSQIP Participant User File is available to any individual who has an official appointment at a fully enrolled ACS-NSQIP site.

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Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Division of Urogynecology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA

    Jessica M. Selle, Erik D. Hokenstad & John A. Occhino

  2. Department of Urogynecology, Billings Clinic, Billings, MT, USA

    Erik D. Hokenstad

  3. Health Care Delivery Research and Administration, Mayo Clinic, Rochester, MN, USA

    Elizabeth B. Habermann

  4. Kern Center Analytics, Mayo Clinic, Rochester, MN, USA

    Katherine A. Bews

Authors
  1. Jessica M. Selle
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  2. Erik D. Hokenstad
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  3. Elizabeth B. Habermann
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  4. Katherine A. Bews
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  5. John A. Occhino
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Contributions

JMS: manuscript writing/editing. EDH: project development, data collection, data analysis, manuscript writing/editing. EBH: project development, data analysis, manuscript writing/editing. KMB: project development, data analysis, manuscript writing/editing. JAO: project development, manuscript writing/editing.

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This is a retrospective coding study and was deemed IRB exempt.

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Selle, J.M., Hokenstad, E.D., Habermann, E.B. et al. The effect of concomitant hysterectomy on complications following pelvic organ prolapse surgery. Arch Gynecol Obstet 309, 321–327 (2024). https://doi.org/10.1007/s00404-023-07112-7

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  • DOI: https://doi.org/10.1007/s00404-023-07112-7

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