Abstract:
INTRODUCTION AND HYPOTHESIS:Support of the vaginal apex is paramount for a durable repair of pelvic organ prolapse (POP). Our aim is to assess national utilization of apical suspension procedures for the surgical treatment of complete POP. We hypothesize that there might be a high rate of apical suspension with advanced prolapse. METHODS:The 2006-2016 National Surgical Quality Improvement Program database was queried for a primary postoperative diagnosis of complete POP. The primary outcome was type of repair. Secondary outcomes included patient characteristics associated with apical suspension or colpocleisis. Procedures were delineated using CPT codes. Chi-squared and multivariate logistic regression analyses were used to evaluate factors associated with repair type. RESULTS:A total of 2,784 women underwent surgery for complete POP with a mean age of 64.6 ± 11.0 years. Overall, 1,300 (46.7%) patients underwent apical suspension: 487 sacrocolpopexies (17.5%), 428 extraperitoneal suspensions (15.4%), and 391 uterosacral suspensions (14.0%). 5.2% (144) underwent colpocleisis, and 47.5% (1,332) of women had a concurrent hysterectomy (CH). With CH, 38.6% (502) had apical suspension or colpocleisis versus 69.5% (940) of post-hysterectomy cases. On logistic regression, CH was inversely associated with apical suspension (adjusted odds ratio [aOR] 0.37, CI 0.32-0.44, p < 0.001). Colpocleisis was associated with older age (aOR 4.9 per 10 years, CI 3.8-6.3, p < 0.001), post-hysterectomy surgery (aOR 0.23, CI 0.1-0.4, p < 0.001 for CH), and higher comorbidity index (OR 1.7, CI 1.1-2.6, p = 0.009). Complication rates are similar with and without apical suspension (8.2% versus 7.0%, p = 0.269). CONCLUSIONS:During surgery for complete POP, an apical suspension procedure is performed in 46.7% of patients and is more common post-hysterectomy.
journal_name
Int Urogynecol Jjournal_title
International urogynecology journalauthors
Slopnick EA,Chapman GC,Roberts K,Sheyn DD,El-Nashar S,Mahajan STdoi
10.1007/s00192-020-04342-0subject
Has Abstractpub_date
2020-06-08 00:00:00eissn
0937-3462issn
1433-3023pii
10.1007/s00192-020-04342-0pub_type
杂志文章abstract:INTRODUCTION AND HYPOTHESIS:To determine whether fecal incontinence (FI) is associated with sexual activity and to compare sexual function in women with and without FI. METHODS:We conducted a retrospective chart review of all new patients seen in an academic urogynecology clinic. Women who reported fecal incontinence,...
journal_title:International urogynecology journal
pub_type: 杂志文章
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journal_title:International urogynecology journal
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journal_title:International urogynecology journal
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journal_title:International urogynecology journal
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journal_title:International urogynecology journal
pub_type: 临床试验,杂志文章
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pub_type: 杂志文章,多中心研究,随机对照试验
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journal_title:International urogynecology journal
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pub_type: 杂志文章
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journal_title:International urogynecology journal
pub_type: 杂志文章,多中心研究
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pub_type: 杂志文章,随机对照试验
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pub_type: 杂志文章
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pub_type: 杂志文章,多中心研究
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pub_type: 杂志文章
doi:10.1007/s00192-012-1849-1
更新日期:2013-04-01 00:00:00
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journal_title:International urogynecology journal
pub_type: 杂志文章,评审
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journal_title:International urogynecology journal
pub_type: 杂志文章
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更新日期:2014-11-01 00:00:00
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pub_type: 杂志文章
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journal_title:International urogynecology journal
pub_type: 杂志文章
doi:10.1007/s00192-017-3472-7
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journal_title:International urogynecology journal
pub_type: 杂志文章
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更新日期:2012-01-01 00:00:00
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pub_type: 杂志文章
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pub_type: 杂志文章
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更新日期:2015-03-01 00:00:00