Thirty-day Morbidity of Abdominal Sacrocolpopexy Is Influenced by Additional Surgical Treatment for Stress Urinary Incontinence

Boysen, William R.; Adamsky, Melanie; Cohen, Andrew J.; Rodríguez, Joseph A.; Faris, Sarah; Bales, Gregory T.

doi:10.1016/j.urology.2017.07.015

Cited by 7 publications

(6 citation statements)

References 23 publications

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“…Overall the risk of adverse events was low, with a slightly increased risk of UTI for patients having an incontinence procedure. This is similar to results observed for pooled data of open and minimally invasive SCP, although our study includes more than twice as many MISCP patients. Our analysis has the advantage of providing relative risk numbers which are often more intuitive to providers and patients.…”

Section: Discussionsupporting

confidence: 90%

“…One motivator for a two‐step approach to management of occult SUI is concern for intraoperative or perioperative complications related to the addition of a procedure that may ultimately not be necessary. Given that there is significant variation in care, and many studies assessing outcomes are underpowered to assess complications, or have included open and minimally invasive patients together in smaller cohorts, further assessment of complication rates by use of large cohort data is beneficial for patient counselling purposes. We aimed to evaluate perioperative 30‐day complication rates at the time of MISCPs performed with and without concomitant incontinence procedures.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Complications after minimally invasive sacrocolpopexy with and without concomitant incontinence surgery: A National Surgical Quality Improvement Program (NSQIP) database study

Clancy

Mallick

Breau

et al. 2018

Neurourology and Urodynamics

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Complications after minimally invasive sacrocolpopexy with and without concomitant incontinence surgery: A National Surgical Quality Improvement Program (NSQIP) database study

Clancy

Mallick

Breau

et al. 2018

Neurourology and Urodynamics

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“…The Matsuoka's metaanalysis demonstrated that there were higher rates of intraoperative complications in the case of combined surgery, primarily associated with bladder perforation, major bleeding, and even bowel or obturator nerve injury [23]. Boysen et al analyzed 4793 patients who underwent abdominal sacrocolpopexy with concurrent sling placement performed in 1627 women and found that combined surgery was associated with higher rates of postoperative urinary tract infection [24].…”

Section: Discussionmentioning

confidence: 99%

Does Previous Pelvic Organ Prolapse Surgery Influence the Effectiveness of the Sub-Urethral Sling Procedure

Horosz¹,

Pomian²,

Zwierzchowska³

et al. 2020

JCM

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Pelvic organ prolapse (POP) often co-occurs with stress urinary incontinence. There is no consensus on whether prolapse repair and anti-incontinence surgery should be performed concomitantly or separately, in a two-step manner. The present study evaluated the effects of the tension-free vaginal tape (TVT) procedure in patients who had previously undergone pelvic floor repair (study group), compared to women who underwent TVT insertion only (control group). The study group comprised 84 patients who underwent the TVT procedure but had previously also undergone surgical POP repair. The control group consisted of 250 women in whom the TVT was inserted. The primary objective was to compare the objective cure rate and the secondary objective was to compare the subjective cure rate in both groups. Negative pad test was achieved in over 91% in both groups. Objective and subjective cure rates were compared, as well as complication rates. Significant improvement was observed in the postoperative 1-h pad test in all patients. In all patients, we observed significant improvement in the quality of life, with no differences between the groups. No differences were found in the occurrence of postoperative urinary retention, urgency and frequency of daytime micturition, or vaginal erosion between the groups. The current results demonstrate that the two-step approach to pelvic reconstruction and anti-incontinence surgery is as safe and effective as primary TVT implantation.

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“…Infections, including urinary tract infection (UTI) and surgical‐site infections, are the most common postoperative complication following clean‐contaminated gynecologic surgery . When MUS is added to concurrent procedures for pelvic reconstruction, this may increase the postoperative risk of UTI . Potential mechanisms include increased length of surgery, repeated intraoperative urethral manipulation with cystoscope and catheter, and higher rates of postoperative urinary retention requiring prolonged catheterization.…”

Section: Introductionmentioning

confidence: 99%

“…4 When MUS is added to concurrent procedures for pelvic reconstruction, this may increase the postoperative risk of UTI. [5][6][7] Potential mechanisms include increased length of surgery, repeated intraoperative urethral manipulation with cystoscope and catheter, and higher rates of postoperative urinary retention requiring prolonged catheterization. Several international guidelines recommend preoperative antibiotic prophylaxis for clean-contaminated procedures including MUS [8][9][10][11] but few make recommendations regarding antibiotic prophylaxis in the early postoperative period, even when catheterization is required.…”

Section: Introductionmentioning

confidence: 99%

Urinary tract infection prevention after midurethral slings in pelvic floor reconstructive surgery: A systematic review and meta‐analysis

Sanaee

Hutcheon

Larouche

et al. 2019

Acta Obstet Gynecol Scand

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Introduction Synthetic midurethral slings are the most common procedures currently performed for stress urinary incontinence in women. Infection is a frequent complication of urogynecologic surgery. We performed a systematic review and meta‐analysis to identify interventions that successfully prevent infections, including urinary tract infection (UTI) and/or bacteriuria, compared with no intervention, in women undergoing midurethral sling surgery with or without concomitant pelvic reconstructive procedures for prolapse. Material and methods The primary outcome was the development of any infection post‐midurethral sling placement in women. MEDLINE, Embase, CINAHL and the Cochrane Library were searched for comparative studies from inception to July 2017, with no language restrictions. We used search terms related to midurethral sling, infections and infection‐reduction interventions. Two independent reviewers abstracted data and assessed study quality. Pooled effect size estimates were calculated. We conducted meta‐analysis of eligible studies. A protocol for this review has been registered and can be accessed online (http://hdl.handle.net/2429/64731). Results We identified seven eligible studies of infection risk‐reducing interventions; all focused on UTIs. Only one study assessed preoperative antibiotics with midurethral sling alone and was halted early because of low UTI rates. All other studies (three randomized control trials and three observational studies) examined whether postoperative antibiotics decrease UTI/bacteriuria rates after midurethral sling with or without reconstructive procedures for pelvic organ prolapse and using bladder catheterization postoperatively. Due to considerable clinical heterogeneity, we only combined four studies for meta‐analysis. Postoperative oral prophylactic nitrofurantoin showed no significant benefit in reducing UTI/bacteriuria in women post‐midurethral sling with or without concomitant reconstructive pelvic surgery and the need for bladder catheterization, when compared with the reference group (pooled relative risk 0.73, 95% confidence interval [CI] 0.42‐1.25). Conclusions Based on the best available evidence, postoperative oral nitrofurantoin is not effective at reducing UTI/bacteriuria rates in catheterized women after midurethral sling with or without concomitant pelvic reconstructive surgery for prolapse. For midurethral sling alone, preoperative antibiotic prophylaxis may not be needed for UTI prevention.

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Thirty-day Morbidity of Abdominal Sacrocolpopexy Is Influenced by Additional Surgical Treatment for Stress Urinary Incontinence

Cited by 7 publications

References 23 publications

Complications after minimally invasive sacrocolpopexy with and without concomitant incontinence surgery: A National Surgical Quality Improvement Program (NSQIP) database study

Complications after minimally invasive sacrocolpopexy with and without concomitant incontinence surgery: A National Surgical Quality Improvement Program (NSQIP) database study

Does Previous Pelvic Organ Prolapse Surgery Influence the Effectiveness of the Sub-Urethral Sling Procedure

Urinary tract infection prevention after midurethral slings in pelvic floor reconstructive surgery: A systematic review and meta‐analysis

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