Perioperative Complications and Cost of Vaginal, Open Abdominal, and Robotic Surgery for Apical Vaginal Vault Prolapse

Mallika Anand, Amy L. Weaver, Kristin M. Fruth, Bijan J Borah, Christopher J. Klingele, John B. Gebhart

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objectives To determine the rate of perioperative complications and cost associated with Mayo-McCall culdoplasty (MMC), open abdominal sacrocolpopexy (ASC), and robotic sacrocolpopexy (RSC) for posthysterectomy vaginal vault prolapse. Methods We retrospectively searched for the records of patients undergoing posthysterectomy apical vaginal prolapse surgery (MMC, ASC, or RSC) between January 1, 2000, and June 30, 2012, at our institution. For all patients identified, perioperative complications, length of hospital stay, and inpatient costs to patients were abstracted from the medical records and compared by procedure. Inverse-probability-of-procedure weighting using propensity scores was used to obtain less-biased comparisons of outcomes between procedures. Results A total of 512 patients met the inclusion criteria (174 MMC, 237 ASC, and 101 RSC). Using inverse-probability weighting, the MMC group had a significantly lower intraoperative complication rate (3.3% vs 11.6% for ASC, 3.4% vs 24.1% for RSC), median operative time (94 vs 217 min for ASC, 100 vs 228 min for RSC), and median cost (US $8,776 vs $12,695 for ASC, US $8,773 vs $13,107 for RSC) than the ASC and RSC groups (all P < 0.01). In addition, the MMC group had significantly fewer postoperative grade 3+ complications than the RSC group (1.1% vs 9.4%, P < 0.01). Conclusions In the treatment of posthysterectomy vaginal vault prolapse, MMC is associated with decreased non-urinary tract infection, less perioperative morbidity, and lower cost to patients compared with sacrocolpopexy.

Original languageEnglish (US)
Pages (from-to)27-35
Number of pages9
JournalFemale Pelvic Medicine and Reconstructive Surgery
Volume23
Issue number1
DOIs
StatePublished - Jan 1 2017

Fingerprint

Pelvic Organ Prolapse
Robotics
Costs and Cost Analysis
Length of Stay
Uterine Prolapse
Propensity Score
Intraoperative Complications
Operative Time
Medical Records
Inpatients
Morbidity

Keywords

  • Mayo-McCall culdoplasty
  • sacrocolpopexy
  • uterosacral ligament

ASJC Scopus subject areas

  • Surgery
  • Obstetrics and Gynecology
  • Urology

Cite this

Perioperative Complications and Cost of Vaginal, Open Abdominal, and Robotic Surgery for Apical Vaginal Vault Prolapse. / Anand, Mallika; Weaver, Amy L.; Fruth, Kristin M.; Borah, Bijan J; Klingele, Christopher J.; Gebhart, John B.

In: Female Pelvic Medicine and Reconstructive Surgery, Vol. 23, No. 1, 01.01.2017, p. 27-35.

Research output: Contribution to journalArticle

Anand, Mallika ; Weaver, Amy L. ; Fruth, Kristin M. ; Borah, Bijan J ; Klingele, Christopher J. ; Gebhart, John B. / Perioperative Complications and Cost of Vaginal, Open Abdominal, and Robotic Surgery for Apical Vaginal Vault Prolapse. In: Female Pelvic Medicine and Reconstructive Surgery. 2017 ; Vol. 23, No. 1. pp. 27-35.
@article{0f965e9b30cd4829906906ed26c9c151,
title = "Perioperative Complications and Cost of Vaginal, Open Abdominal, and Robotic Surgery for Apical Vaginal Vault Prolapse",
abstract = "Objectives To determine the rate of perioperative complications and cost associated with Mayo-McCall culdoplasty (MMC), open abdominal sacrocolpopexy (ASC), and robotic sacrocolpopexy (RSC) for posthysterectomy vaginal vault prolapse. Methods We retrospectively searched for the records of patients undergoing posthysterectomy apical vaginal prolapse surgery (MMC, ASC, or RSC) between January 1, 2000, and June 30, 2012, at our institution. For all patients identified, perioperative complications, length of hospital stay, and inpatient costs to patients were abstracted from the medical records and compared by procedure. Inverse-probability-of-procedure weighting using propensity scores was used to obtain less-biased comparisons of outcomes between procedures. Results A total of 512 patients met the inclusion criteria (174 MMC, 237 ASC, and 101 RSC). Using inverse-probability weighting, the MMC group had a significantly lower intraoperative complication rate (3.3{\%} vs 11.6{\%} for ASC, 3.4{\%} vs 24.1{\%} for RSC), median operative time (94 vs 217 min for ASC, 100 vs 228 min for RSC), and median cost (US $8,776 vs $12,695 for ASC, US $8,773 vs $13,107 for RSC) than the ASC and RSC groups (all P < 0.01). In addition, the MMC group had significantly fewer postoperative grade 3+ complications than the RSC group (1.1{\%} vs 9.4{\%}, P < 0.01). Conclusions In the treatment of posthysterectomy vaginal vault prolapse, MMC is associated with decreased non-urinary tract infection, less perioperative morbidity, and lower cost to patients compared with sacrocolpopexy.",
keywords = "Mayo-McCall culdoplasty, sacrocolpopexy, uterosacral ligament",
author = "Mallika Anand and Weaver, {Amy L.} and Fruth, {Kristin M.} and Borah, {Bijan J} and Klingele, {Christopher J.} and Gebhart, {John B.}",
year = "2017",
month = "1",
day = "1",
doi = "10.1097/SPV.0000000000000345",
language = "English (US)",
volume = "23",
pages = "27--35",
journal = "Female Pelvic Medicine and Reconstructive Surgery",
issn = "2151-8378",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - Perioperative Complications and Cost of Vaginal, Open Abdominal, and Robotic Surgery for Apical Vaginal Vault Prolapse

AU - Anand, Mallika

AU - Weaver, Amy L.

AU - Fruth, Kristin M.

AU - Borah, Bijan J

AU - Klingele, Christopher J.

AU - Gebhart, John B.

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Objectives To determine the rate of perioperative complications and cost associated with Mayo-McCall culdoplasty (MMC), open abdominal sacrocolpopexy (ASC), and robotic sacrocolpopexy (RSC) for posthysterectomy vaginal vault prolapse. Methods We retrospectively searched for the records of patients undergoing posthysterectomy apical vaginal prolapse surgery (MMC, ASC, or RSC) between January 1, 2000, and June 30, 2012, at our institution. For all patients identified, perioperative complications, length of hospital stay, and inpatient costs to patients were abstracted from the medical records and compared by procedure. Inverse-probability-of-procedure weighting using propensity scores was used to obtain less-biased comparisons of outcomes between procedures. Results A total of 512 patients met the inclusion criteria (174 MMC, 237 ASC, and 101 RSC). Using inverse-probability weighting, the MMC group had a significantly lower intraoperative complication rate (3.3% vs 11.6% for ASC, 3.4% vs 24.1% for RSC), median operative time (94 vs 217 min for ASC, 100 vs 228 min for RSC), and median cost (US $8,776 vs $12,695 for ASC, US $8,773 vs $13,107 for RSC) than the ASC and RSC groups (all P < 0.01). In addition, the MMC group had significantly fewer postoperative grade 3+ complications than the RSC group (1.1% vs 9.4%, P < 0.01). Conclusions In the treatment of posthysterectomy vaginal vault prolapse, MMC is associated with decreased non-urinary tract infection, less perioperative morbidity, and lower cost to patients compared with sacrocolpopexy.

AB - Objectives To determine the rate of perioperative complications and cost associated with Mayo-McCall culdoplasty (MMC), open abdominal sacrocolpopexy (ASC), and robotic sacrocolpopexy (RSC) for posthysterectomy vaginal vault prolapse. Methods We retrospectively searched for the records of patients undergoing posthysterectomy apical vaginal prolapse surgery (MMC, ASC, or RSC) between January 1, 2000, and June 30, 2012, at our institution. For all patients identified, perioperative complications, length of hospital stay, and inpatient costs to patients were abstracted from the medical records and compared by procedure. Inverse-probability-of-procedure weighting using propensity scores was used to obtain less-biased comparisons of outcomes between procedures. Results A total of 512 patients met the inclusion criteria (174 MMC, 237 ASC, and 101 RSC). Using inverse-probability weighting, the MMC group had a significantly lower intraoperative complication rate (3.3% vs 11.6% for ASC, 3.4% vs 24.1% for RSC), median operative time (94 vs 217 min for ASC, 100 vs 228 min for RSC), and median cost (US $8,776 vs $12,695 for ASC, US $8,773 vs $13,107 for RSC) than the ASC and RSC groups (all P < 0.01). In addition, the MMC group had significantly fewer postoperative grade 3+ complications than the RSC group (1.1% vs 9.4%, P < 0.01). Conclusions In the treatment of posthysterectomy vaginal vault prolapse, MMC is associated with decreased non-urinary tract infection, less perioperative morbidity, and lower cost to patients compared with sacrocolpopexy.

KW - Mayo-McCall culdoplasty

KW - sacrocolpopexy

KW - uterosacral ligament

UR - http://www.scopus.com/inward/record.url?scp=85010032110&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85010032110&partnerID=8YFLogxK

U2 - 10.1097/SPV.0000000000000345

DO - 10.1097/SPV.0000000000000345

M3 - Article

C2 - 27682746

AN - SCOPUS:85010032110

VL - 23

SP - 27

EP - 35

JO - Female Pelvic Medicine and Reconstructive Surgery

JF - Female Pelvic Medicine and Reconstructive Surgery

SN - 2151-8378

IS - 1

ER -