Prevalence of and Risk Factors for Emergency Department Visits Following Outpatient Gynecologic Surgery

Chaves, K.F.; Apple, Annie; Hassoun, Jenine; Robinson, Marc; D, Tan; Zhao, Zhiguo; Yunker, Amanda

doi:10.1016/j.jmig.2020.08.237

Cited by 2 publications

(2 citation statements)

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“…Reported rates of ED visits within 30 days of surgery for a benign gynecologic surgery population have been published and range from 5% to 9.1%, and readmission rates range from 0.2% to 3.5%. [24][25][26] Comparatively, those patients who have undergone MUS placement have reported ED visit rates in the literature of 4.7%, with a 0.01-1.16% readmission rate. [27][28][29][30] The ED visit rates and readmission rates in the concurrent surgery group in this study were found to be higher than those reported in the literature.…”

Section: Discussionmentioning

confidence: 99%

“…Most of the benign gynecologic procedures in this study are considered major surgery, whereas MUS placement alone is considered minor surgery. Reported rates of ED visits within 30 days of surgery for a benign gynecologic surgery population have been published and range from 5% to 9.1%, and readmission rates range from 0.2% to 3.5% 24–26 . Comparatively, those patients who have undergone MUS placement have reported ED visit rates in the literature of 4.7%, with a 0.01–1.16% readmission rate 27–30 .…”

Section: Discussionmentioning

confidence: 99%

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Assessment of Adverse Events in a Matched Cohort of Women Undergoing Concurrent Midurethral Sling at the Time of Minimally Invasive Benign Gynecologic Surgery

Wood¹,

Casas-Puig

Ferrando

2022

UROGC

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Importance Procedures for stress urinary incontinence and benign gynecologic surgery are often performed concurrently, and associated complication rates have previously been unexplored. Objective The aim of this study was to compare postoperative complication rates between women undergoing midurethral sling (MUS) placement at the time of benign gynecologic surgery and those undergoing MUS alone. Study Design This was a retrospective matched cohort study of women undergoing MUS with or without concurrent minimally invasive benign gynecologic surgery from January 2010 through December 2020. Eligible women undergoing concurrent surgery were matched to a cohort of women undergoing MUS placement alone. The electronic medical record was queried for demographic and perioperative/postoperative data up to 12 months after surgery. Results Thirty-eight women met inclusion criteria for the concurrent group, and 152 women were matched accordingly. The overall adverse event rate was 39.5% (95% confidence interval [CI], 0.25–0.55) for the concurrent group and 24.3% (95% CI, 0.18–0.32) for the MUS-only group (P = 0.05). Adverse events with Clavien-Dindo grade ≤ 2 were higher in the concurrent group (Clavien-Dindo Grade 1: 5% vs 0%, P = 0.04; Clavien-Dindo Grade 2: 16% vs 6%, P = 0.04), as was composite postoperative resource utilization (76% vs 49%, P = 0.003). Mesh exposure (P = 0.03) and sling lysis/excision rates (P = 0.02) were higher in the concurrent group. On logistic regression, concurrent surgery cases remained significantly associated with sling mesh erosion (adjusted odds ratio, 12.6; 95% CI, 1.4–116.4). Conclusions Midurethral sling placement at the time of minimally invasive benign gynecologic surgery is safe but is associated with a higher incidence of postoperative hospital resource utilization and sling mesh extrusion, and a need for revision.

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