4.2 Article

The effect of age on complications in women undergoing minimally invasive sacral colpopexy

Journal

INTERNATIONAL UROGYNECOLOGY JOURNAL
Volume 25, Issue 9, Pages 1251-1256

Publisher

SPRINGER LONDON LTD
DOI: 10.1007/s00192-014-2391-0

Keywords

Minimally invasive sacral colpopexy; Perioperative complications; Elderly; Vaginal prolapse

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Previous research has demonstrated similar complication rates in older and younger women undergoing abdominal sacral colpopexy via laparotomy. The objective of this study was to compare perioperative complications in older and younger women undergoing minimally invasive sacral colpopexy. This was a retrospective study of laparoscopic and robotic sacral colpopexies performed from January 2009 to May 2012 at a large academic center. Patient demographics, surgical data, and perioperative complications were compared in women < 65 and a parts per thousand yen65 years of age. Primary outcome was the difference in major complications. A total of 302 women underwent minimally invasive sacral colpopexy during the study period. Mean age was 58.5 +/- 8.8 years and 84 subjects (27.8 %) were a parts per thousand yen65 years. Older women were more likely to have had a prior hysterectomy (60.7 vs 39.0 %, p = 0.001) and had more severe preoperative prolapse (86.9 % vs 71.9 % a parts per thousand yen POPQ stage III, p = 0.01). There was no significant difference in duration of hospitalization (1.4 vs 1.4 days, p = 0.54). Overall, there were significantly more major complications in women a parts per thousand yenaEuro parts per thousand 65 years (unadjusted OR 1.84, 95 % CI 1.02-3.35, p = 0.04). After controlling for BMI, route of surgery, estimated blood loss (EBL), and operating room time, age a parts per thousand yenaEuro parts per thousand 65 remained a significant predictor of complications (adjusted OR 2.28, 95 % CI 1.21-4.29, p = 0.01). Our findings suggest that older women have a higher rate of major complications following minimally invasive sacral colpopexy, even after controlling for BMI, route of surgery, EBL, and operating room time. This increased risk should be addressed during preoperative counseling and may influence surgical planning.

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