Serious complications and recurrences after pelvic organ prolapse surgery for 2309 women in the VIGI‐MESH registry. (20th September 2021)

• Record Type: Journal Article
• Authors: Fritel, X; de Tayrac, R; de Keizer, J; Campagne‐Loiseau, S; Cosson, M; Ferry, P; Deffieux, X; Lucot, J‐P; Wagner, L; Debodinance, P; Saussine, C; Pizzoferrato, A‐C; Carlier‐Guérin, C; Thubert, T; Panel, L; Bosset, P‐O; Nkounkou, E; Ramanah, R; Boisramé, T; Charles, T; Raiffort, C; Charvériat, A; Ragot, S; Fauconnier, A
• Other Names: Aboukassem Adnan investigator.; Akladios Chérif investigator.; Arsène Emmanuelle investigator.; Aucouturier Jean‐Sébastien investigator.; Bader Georges investigator.; Bailly Emmanuel investigator.; Baldauf Jean‐Jacques investigator.; Bartolo Stéphanie investigator.; Barussaud Marie‐Line investigator.; Béchard Fanny investigator.; Bernardeau Simon investigator.; Biscans Clément investigator.; Boodhun Deepak investigator.; Botchorishvili Revaz investigator.; Boukaram Michel investigator.; Brams Aude investigator.; Bressler Laurent investigator.; Bruhat Clément investigator.; Canis Michel investigator.; Cavillon Victor investigator.; Celhay Olivier investigator.; Chevrot Armand investigator.; Collinet Pierre investigator.; Cornille Arnaud investigator.; Costa Pierre investigator.; Courtieu Christophe investigator.; Courtois Laurent investigator.; Curinier Sandra investigator.; Darnis Eric investigator.; Delpech Pierre‐Olivier investigator.; Delporte Véronique investigator.; Dubois Anne investigator.; Faller Emilie investigator.; Fatton Brigitte investigator.; Féyeux Cécile investigator.; Gabriele Victor investigator.; Gadonneix Pierre investigator.; Garbin Olivier investigator.; Genty Florent investigator.; Giraudet Géraldine investigator.; Gres Pascale investigator.; Gueudry Pauline investigator.; Haab Jean‐François investigator.; Hedde Audrey investigator.; Host Aline investigator.; Hummel Michel investigator.; Gautier Estelle Jean dit investigator.; Kane Aminata investigator.; Gouic Sophie investigator.; Teuff Isabelle investigator.; Lebreton Gil investigator.; Lecointre Lise investigator.; Léon Grégoire investigator.; Maisonnette Yolande investigator.; Martin Lucile investigator.; Marx Aurore investigator.; Mouracade Pascal investigator.; Palamara Corinne investigator.; Nicolas Petit investigator.; Pettenati Caroline investigator.; Peyrat Laurence investigator.; Pillot Pierre investigator.; Pouly Jean‐Luc investigator.; Poupon Clothilde investigator.; Prudhomme Michel investigator.; Rabishong Benoît investigator.; Ricard Hélène investigator.; Ripoche Jérémie investigator.; Rivaux Géraldine investigator.; Salerno Jennifer investigator.; Salet‐Lizée Delphine investigator.; Sarfati Richard investigator.; Sarradin Maxence investigator.; Schuller Elodie investigator.; Segaert An investigator.; Stoll François investigator.; Thirouard Yannick investigator.; Trichot Caroline investigator.; Turck Mélusine investigator.; Vandendriessche David investigator.; Vaucel Edouard investigator.; Vieillefosse Sarah investigator.; Villot Anne investigator.; Vinatier Denis investigator.; Vincens Etienne investigator.; Vinchant Marie investigator.; Vinson‐Bonnet Béatrice investigator.; Wapler Soraya investigator.; Warembourg Sophie investigator.;
• Is Part Of: BJOG. Volume 129:Number 4(2022)
• Page Start: 656
• Page End: 663
• Publication Date: 2021-09-20
• Subjects: Longitudinal study -- mesh -- pelvic organ prolapse -- registry -- surgical complication; Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1111/1471-0528.16892
• Languages: English
• ISSNs: 1470-0328

Abstract

Abstract : Objective: To assess the incidence of serious complications and reoperations for recurrence after surgery for pelvic organ prolapse (POP) and compare the three most common types of repair. Design: Prospective cohort study using a registry. Setting: Nineteen French surgical centres. Population: A total of 2309 women participated between 2017 and 2019. Methods: A multivariate analysis including an inverse probability of treatment weighting approach was used to obtain three comparable groups. Main outcome measures: Serious complications and subsequent reoperations for POP recurrence. Results: The median follow‐up time was 17.6 months. Surgeries were native tissue vaginal repairs ( n = 504), transvaginal mesh placements ( n = 692) and laparoscopic sacropexies with mesh ( n = 1113). Serious complications occurred among 52 women (2.3%), and reoperation for POP recurrence was required for 32 women (1.4%). At 1 year the cumulative weighted incidence of serious complications was 1.8% for native tissue vaginal repair, 3.9% for transvaginal mesh and 2.2% for sacropexy, and the rates for reoperation for recurrence of POP were 1.5, 0.7 and 1.1%, respectively. Compared with native tissue vaginal repair, the risk of serious complications was higher in the transvaginal mesh group (weighted hazard ratio, wHR 3.84, 95% CI 2.43–6.08) and the sacropexy group (wHR 2.48, 95% CI 1.45–4.23), whereas the risk of reoperation for prolapse recurrence was lower in both the transvaginal mesh (wHR 0.22, 95% CI 0.13–0.39) and sacropexy (wHR 0.29, 95% CI 0.18–0.47) groups. Conclusions: Our results suggest that native tissue vaginal repairs have the lowest risk of serious complications but the highest risk of reoperation for recurrence. These results are useful for informing women and for shared decision making. Tweetable abstract: Laparoscopic sacropexy had fewer serious complications than transvaginal mesh and fewer reoperations for recurrence than vaginal repair. Tweetable abstract: Laparoscopic sacropexy had fewer serious complications than transvaginal mesh and fewer reoperations for recurrence than vaginal repair.