Advanced gynecologic surgery in women with Parkinson's disease

Objective: To assess the effect of Parkinson's disease (PD) on perioperative outcomes following gynecologic surgery. Background: Gynecological complaints are common among women with PD but under-reported, under-diagnosed and under-treated, in part due to surgical hesitancy. Non-surgical management options are not always acceptable to patients. Advanced gynecologic surgeries are effective for symptom management. Hesitancy toward elective surgery in PD stems from concern regarding perioperative risks. Methods: This retrospective cohort study derived data by querying the Nationwide Inpatient Sample (NIS) database between 2012 and 2016 to identify women who underwent advanced gynecologic surgery. Non -parametric Mann-Whitney U and Fisher exact tests were used to compare quantitative and categorical vari-ables respectively. Age and Charlson Comorbidity Index values were used to create matched cohorts. Results: 526 (0.1%) women with and 404,758 without a diagnosis of PD underwent gynecological surgery. Median age of patients with PD (70 years vs 44 years, p < 0.001) and median comorbid conditions (4 vs 0, p < 0.001) were higher compared to counterparts. Median length of stay (LOS) was longer in PD group (3 days vs 2 days, p < 0.001) with lower rates of routine discharge (58% vs 92%, p = 0.001). Groups were comparable in post-operative mortality (0.8% vs 0.3%, p = 0.076). After matching, there was no difference in LOS (p = 0.346) or mortality (0.8% vs 1.5%, p = 0.385) and PD group was more likely to be discharged to skilled nursing facilities. Conclusion: PD does not worsen perioperative outcomes following gynecologic surgery. Neurologists may use this information to provide reassurance to women with PD undergoing such procedures.

Automated summary

The objective of this study was to assess the effect of Parkinson's disease on perioperative outcomes following gynecologic surgery. The study found that Parkinson's disease does not worsen perioperative outcomes, and neurologists can use this information to provide reassurance to women with Parkinson's disease undergoing such procedures.