Complications after surgical repair for Urinary Incontinence or pelvic organ prolapse in women. One center retrospective study.

Charveriat A1, Tartarin F2, Merlet L2, Laurence B3, Fritel X1

Research Type

Clinical

Abstract Category

Female Stress Urinary Incontinence (SUI)

Abstract 367
Open Discussion ePosters
Scientific Open Discussion Session 21
Thursday 30th August 2018
13:10 - 13:15 (ePoster Station 6)
Exhibition Hall
Stress Urinary Incontinence Pelvic Organ Prolapse Outcomes Research Methods
1. Centre Hospitalier Universitaire de Poitiers, Service de Gynécologie Obstétrique et Médecine de la Reproduction - Poitiers (France), 2. Centre d'Investigation Clinique INSERM 1402 - Poitiers (France), 3. Centre Hospitalier Universitaire de Poitiers, Département d'Information Médicale - Poitiers (France)
Presenter
A

Amelie Charveriat

Links

Poster

Abstract

Hypothesis / aims of study
We need more data about the incidence of severe complication after surgical repair for urinary incontinence (UI) or pelvic organ prolapse (POP) in women.

This study is looking to assess the rate of complications following a surgery urinary incontinence or pelvic organ prolapse in women with or without meshes, using data from the IMD and hospital charts.
Study design, materials and methods
In France, all surgery and complications during an hospitalization are coded by the Information Medical Department (IMD) using the International Statistical Classification of Diseases (ICD) and the Common Classification of Medical Acts (CCAM). This is a retrospective and observational study, in a single-center (teaching hospital) from January 2011 to December 2017. We included all women who have received, according to the ICD or CCAM classification, a surgery surgery for urinary incontinence or pelvic organ prolapse. We included mid-urethra sling (MUS) or colposuspension, vaginal repair surgery with or without mesh, abdominal or laparoscopic repair surgery, and endoanal surgery. Artificial sphincters, balloons and periurethral injections were excluded.

Complications were identified using ICD and CCAM classification and systematic review of all hospital charts. The Clavien-Dindo classification has five grades. A grade III complication require a surgical, endoscopic or radiological intervention (grade IIIa intervention not under general anesthesia and grade IIIb under general anesthesia). A grade IV complication need a life threatening complication and a grade V complication is the death of a patient. We considered only grade III or above, as per the Clavien-Dindo classification, and hospitalization in an Intensive Care Unit within 60 days of surgery. Failure or recurrence of incontinence or prolapse were not considered as a severe complication.
Results
We have included 669 women who undergone one or more surgical procedures. Twenty-four women were operated several times for recurrences. Overall, we found 693 surgeries for UI or POP (Table 1).

Ninteen per-operative complications (2.7%) have been identified (Table 2).

We have also identified 68 post operative complications (9.8%) grade III or more according to the Clavien-Dindo classification (Table 3). Grade IIIb complications are detailed in Table 4.

One grade IV complication and one grade V complication have also been identified: a fecal peritonitis after a surgery for rectal prolapse, with an unfavorable evolution, a second surgery was attempted which led to a fatality.
Interpretation of results
Over 7 years thanks to the ICD and CCAM classifications, we have been able to assemble 693 surgery of the prolapse, or to address urinary incontinence with or without meshes. We found 9.8% of the complications grade III and above. Our method does not include complications treated in another center. We were able to underestimate the rate of complications of the pelvic floor repaired surgeries.
Concluding message
It seems useful to want to monitor, in a prospective study, the complications of surgical repair for urinary incontinence or pelvic organ prolapse, including that of the other centers.
Figure 1
Disclosures
Funding None Clinical Trial No Subjects Human Ethics not Req'd It was a retrospective analysis Helsinki Yes Informed Consent Yes
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