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J Urol. 2014 Sep;192(3):788-92. doi: 10.1016/j.juro.2014.03.040. Epub 2014 Mar 15.

Risk factors for 30-day perioperative complications after Le Fort colpocleisis.

Author information

1
Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
2
Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
3
Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

Abstract

PURPOSE:

We identified rates of and risk factors for complications after colpocleisis using the American College of Surgeons NSQIP® database.

MATERIALS AND METHODS:

Women treated with Le Fort colpocleisis from 2005 to 2011 were identified in the database. Primary outcomes were 30-day complication rates. Secondary outcomes were risk factors for complications and the impact of age and a concomitant sling on morbidity. Clinical and procedural characteristics were compared using the chi-square test and 1-way ANOVA.

RESULTS:

We identified 283 women, of whom 23 (8.1%) experienced complications. The most common complication was urinary tract infection in 18 women (6.4%). There was 1 death for a 0.4% mortality rate. Increased complications were associated with age less than 75 years (p = 0.03), chronic obstructive pulmonary disease (p = 0.03), hemiplegia (p = 0.03), disseminated cancer (p = 0.03) and open wound infection (p = 0.02). Six patients (2.1%) required return to the operating room within 30 days. Complication rates did not differ based on operative time (p = 0.78), inpatient status (p = 0.24), resident involvement (p = 0.35), concomitant sling placement (p = 0.81) or anesthesia type (p = 0.27). Women undergoing colpocleisis without (191) and with (92) a sling had similar baseline characteristics. Colpocleisis without and with a sling had similar rates of complications (7.9% vs 8.7%, p = 0.81), urinary tract infection (5.8% vs 7.6%, p = 0.55), return to the operating room (2.1% vs 2.2%, p = 0.97) and mortality (0% vs 1.1%, p = 0.15).

CONCLUSIONS:

Mortality and complication rates after colpocleisis are low with urinary tract infection being the most common postoperative complication. Concomitant sling placement does not increase 30-day complication rates.

KEYWORDS:

aged; gynecologic surgical procedures; postoperative complications; urinary tract; uterine prolapse

PMID:
24641911
DOI:
10.1016/j.juro.2014.03.040
[Indexed for MEDLINE]
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