Impact of Bariatric Surgery on Complications After Prolapse Surgery

ImportanceObesity is a risk factor for pelvic organ prolapse (POP) and independently associated with perioperative complications following prolapse surgery. Although weight loss surgery (WLS) may lead to weight loss and mitigate obesity-related comorbidities, it is associated with chronic malabsorption, which may also lead to increased perioperative complications. There have been no studies evaluating the impact of prior WLS on POP surgery outcomes.ObjectiveThis study aimed to describe the effect of WLS on complications after POP surgery.Study DesignWe performed a retrospective cohort study of patients with obesity who underwent POP surgery and compared outcomes between those with and without a prior history of WLS. Data were procured from the Premier U.S. National Database between January 2000 and March 2020.ResultsOf 22,905 surgical procedures performed for POP, 542 (2.2%) previously underwent WLS with a median of 30 months between procedures (IQR, 15-51). The WLS group had higher rates of postoperative mesh erosion at 3 months (3.0% vs 1.5%, P = 0.0079) and 12 months (3.1% vs 1.8%, P = 0.04) and had higher hematoma incidence (1.7% vs 0.68%, P = 0.014). After adjusting for covariates, WLS was not associated with increased probability of infectious (OR, 0.94; 95% CI, 0.67-1.27) or noninfectious morbidity (OR, 1.06; 95% CI, 0.59-1.75). Rates of recurrent prolapse resulting in surgery were similar between groups (1.7% vs 1.3%, P = 0.56), and time interval between WLS and POP surgical procedures did not affect rates of complications.ConclusionWLS does not appear to increase the risk of perioperative complications following surgery for POP.