Colpocleisis: A Safe, Minimally Invasive Option for Pelvic Organ Prolapse

被引:39
作者
Mueller, Margaret G. [1 ,2 ]
Ellimootil, Chandy [3 ,4 ]
Abernethy, Melinda G. [1 ,2 ]
Mueller, Elizabeth R. [3 ,4 ]
Hohmann, Samuel [5 ]
Kenton, Kimberly [1 ,2 ]
机构
[1] Northwestern Univ, Feinberg Sch Med, Dept Obstet & Gynecol, Chicago, IL 60611 USA
[2] Northwestern Univ, Feinberg Sch Med, Dept Urol, Chicago, IL 60611 USA
[3] Loyola Univ Chicago, Stritch Sch Med, Dept Obstet & Gynecol, Maywood, IL USA
[4] Loyola Univ Chicago, Stritch Sch Med, Dept Urol, Maywood, IL USA
[5] Univ Hlth Consortium, Dept Data & Informat Res, Chicago, IL USA
来源
FEMALE PELVIC MEDICINE AND RECONSTRUCTIVE SURGERY | 2015年 / 21卷 / 01期
关键词
colpocleisis; pelvic organ prolapse; surgical outcomes; urogynecology; MORTALITY; MANAGEMENT; OUTCOMES; VOLUME; IMPACT;
D O I
10.1097/SPV.0000000000000114
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Objective: This study aimed to describe the morbidity and mortality associated with colpocleisis and factors associated with improved outcomes. Methods: We used University HealthSystem Consortium database, which included inpatient data from US hospitals. We included all women who underwent colpocleisis from 2002 to 2012. Centers were categorized geographically and by annual case volume. Cases were grouped by age and provider specialty. Outcome and readmission data from participating hospitals were compared between groups by analysis of variance and Tukey statistics. Average length of stay (LOS), intensive care unit (ICU) admission rate, complication rate, mortality rate, and readmission rate were calculated for each hospital and compared. Results: Colpocleisis procedures (4776) were performed at 145 US medical centers. Forty-three percent of procedures were done on women older than 80 years, 52% on women 60 to 79 years, 3% on women 40 to 59 years, and 0.9% on women 20 to 39 years. Overall, rates of complications, ICU admission, and mortality were low with average rates of 6.82%, 2.80%, and 0.15%, respectively. High-volume centers had lower ICU admission and complications rates as well as a shorter LOS. Younger women had higher ICU admission and complication rates as well longer LOS. Stratification by provider specialty demonstrated higher ICU admission rates among cases performed by urologists as compared to cases performed by urogynecologists and general obstetrician-gynecologists. Complication rates were also higher among obstetrician-gynecologists and urologists as compared to urogynecologists. Length of stay was significantly longer when colpocleisis was performed by urologists rather than a urogynecologists. Conclusions: Colpocleisis is a safe minimally invasive procedure and outcomes are influenced by provider specialty and hospital volume.
引用
收藏
页码:30 / 33
页数:4
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