E-Posters-The Impact of Prior Prolapse Repairs on Surgical Outcomes With Minimally Invasive Sacral Colpopexy

The Impact of Prior Prolapse Repairs on Surgical Outcomes With Minimally Invasive Sacral Colpopexy - Jonathan P. Shepherd, MD, MSc

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This study aimed to determine whether prior prolapse repair impacts surgical outcomes in women undergoing minimally invasive sacral colpopexy for recurrent prolapse compared to women undergoing initial prolapse repair. The study included 816 subjects with a mean age of 59.6 years, predominantly Caucasian (97.8%), and with a median parity of 2. The majority of subjects had stage III prolapse (69.9%), followed by stage II (23%) and stage IV (6.9%). The median follow-up at 31 weeks showed that 6.25% of subjects had prolapse recurrence, but a history of prior prolapse repair did not impact recurrence.<br /><br />Complications were observed in 13.4% of subjects, but it was not influenced by prior prolapse repair. Prior prolapse repair did reduce the operating room (OR) time on unadjusted analysis, but when adjusted for confounders in multivariable regression, there was no impact on OR time. Linear regression analysis showed that age, number of circulator turnovers, concomitant lysis of adhesions, preoperative GH strain, and preoperative PB strain were all predictors of change in OR time.<br /><br />Logistic regression analysis showed that preoperative AP, previous history of stroke, and preoperative GH were all associated with increased risk of prolapse recurrence, but a previous prolapse repair did not significantly impact recurrence. Preoperative PB, preoperative GH, concomitant MUS, and obesity were all predictors of major complications, but previous prolapse repair did not significantly impact complication rates.<br /><br />In conclusion, this study found that a history of prior prolapse repair did not have a significant impact on recurrence or complication rates in women undergoing minimally invasive sacral colpopexy for recurrent prolapse. OR time was also not affected by prior prolapse repair. These findings suggest that a prior prolapse repair should not be considered a contraindication for minimally invasive sacral colpopexy in women with recurrent prolapse.

Keywords

prior prolapse repair

surgical outcomes

minimally invasive sacral colpopexy

recurrent prolapse

initial prolapse repair

age

parity

prolapse stage

prolapse recurrence

complications