Complications after Apical Vaginal Prolapse Surgeries (vaginal, robotic, laparoscopic): 5-year Experience and the Role of Surgeon on Outcomes
IUGA Academy. Badalian S. Jun 30, 2018; 212938; 485 Topic: Pelvic Organ Prolapse
Prof. Dr. Samuel Badalian
Prof. Dr. Samuel Badalian

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485

Complications after apical vaginal prolapse surgeries (vaginal, robotic, laparoscopic): 5-year experience and the role of surgeon on outcomes

Badalian, S1

1: SUNY Upstate Medical University, Gynecology and Urogynecology Center

Objective: The objective of this study was to report the rate and type of complications after different types of apical vaginal prolapse surgeries in a single center over a period of 5 years.

Method: We performed a retrospective study for patients with apical vaginal prolapse who underwent pelvic reconstructive surgeries (robotic, laparoscopic, vaginal procedures with and without mesh) between January 2012 and September 2017 at St. Joseph’s Hospital Health Center. We analyzed also the role of the surgeon on outcomes of sacrocolpopexy and vaginal prolapse surgery with mesh.

Results: Nine hundred sixty-five apical prolapse surgeries were performed: 112 Lefort colpocleisis, 220 uterosacral ligament suspensions (USLS), 381 sacrospinous ligament suspensions (SSLS), 116 vaginal mesh surgeries and 136 sacrocolpopexies (45 robotic and 91 laparoscopic). No serious complications were reported after Lefort colpocleisis with 98% success rate (110/112). Complications were very low after USLS and SSLS. The surgical success rates were 67.4% (148/220) for USLS and 72.5% (276/381) for SSLF. Serious adverse events were 9.5% for USLS and 11.7% for SSLF. Vaginal mesh-related complications were 4.3 % with 84 % success rate (97/116). Robotic and laparoscopic sacrocolpopexy procedures had 91 % success rate (123/136) and mesh-related complications were 2.9 % with low serious adverse events (10.2% for robotic group vs 6.7% for laparoscopic).

Conclusion: Pelvic reconstructive surgeons need to appropriately choose the procedure for apical vaginal prolapse by considering all possible complications. Surgeon experience must be a consideration when reporting robotic/laparoscopic sacrocolpopexy complications and mesh-related complications after vaginal mesh surgeries.

Disclosure:

Work supported by industry: no.

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