Effect of Time of Year on Surgical Outcomes in Patients Undergoing Minimally Invasive Sacral Colpopexy or Uterosacral Ligament Suspension

Importance Academic urogynecologists incorporating fellows/residents into operative cases must ensure safety and quality outcomes throughout the learning curve of the academic year. Objectives We evaluated if the month of year relative to fellow/resident promotions in July affects operating time, complications, and prolapse recurrence for minimally invasive sacral colpopexy (MISC) or uterosacral ligament suspension (USLS). Study Design This was a retrospective study comprising MISC and USLS from January 2009 to August 2015. Patient demographics, clinical, and surgical data were compared between months with July as month 1. Linear regression assessed operating time. Logistic regression assessed prolapse recurrence (composite of any POP-Q point beyond the hymen, pessary use, or reoperation) and complications. Results One thousand seven participants had a mean age of 59.9 ± 9.4, body mass index of 27.6 ± 4.2, gravity of 3.0 ± 1.5, and parity of 2.6 ± 1.1. Most had stage III (67.7%) or II prolapse (25.6%). Minimally invasive sacral colpopexy represented 81.0% (58.8% laparoscopic, 41.2% robotic). Uterosacral ligament suspensions were 68.1% vaginal versus laparoscopic/robotic. Median follow-up was 34 weeks (interquartile range, 11–82). Mean operating time was 199.8 ± 66.4 minutes with no impact by month (P = 0.26). Minimally invasive sacral colpopexy (vs USLS, β = 36.4 minutes), conversion to laparotomy (β = 112.9 minutes), and concomitant hysterec...
Source: Female Pelvic Medicine and Reconstructive Surgery - Category: OBGYN Tags: Original Articles Source Type: research