PD50-04 TRANSVAGINAL MESH INCREASES THE RISK OF BLEEDING AND ORGAN SURGICAL SITE INFECTION IN VAGINAL PELVIC RECONSTRUCTION SURGERY: RESULTS FROM A MULTI-INSTITUTIONAL PROSPECTIVELY MAINTAINED DATASET

Abstract

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Pelvic Prolapse1 Apr 2015PD50-04 TRANSVAGINAL MESH INCREASES THE RISK OF BLEEDING AND ORGAN SURGICAL SITE INFECTION IN VAGINAL PELVIC RECONSTRUCTION SURGERY: RESULTS FROM A MULTI-INSTITUTIONAL PROSPECTIVELY MAINTAINED DATASET Devin Haddad, Louis Krane, Gopal Badlani, and Majid Mirzazadeh Devin HaddadDevin Haddad More articles by this author , Louis KraneLouis Krane More articles by this author , Gopal BadlaniGopal Badlani More articles by this author , and Majid MirzazadehMajid Mirzazadeh More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2012AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Vaginal reconstructive surgery can be performed with or without mesh based on surgeon preference. To elucidate small differences in perioperative morbidity following vaginal reconstructive procedures, we elected to look at a national dataset to determine whether using mesh during vaginal pelvic reconstruction surgery impacts rates of various perioperative complications and readmission. METHODS Using the National Surgical Quality Improvement Program (NSQIP) database we concatenated surgical data from multiple vaginal procedures, including anterior and posterior colporrhaphy, paravaginal defect repair, enterocele repair, and colpopexy using CPT coding. We stratified this data by the modifier associated with mesh usage at the time of the procedure. In measuring multiple covariates, we compared various 30-day perioperative outcomes, postoperative complications, and readmission rates. RESULTS We identified 5644 procedures without mesh and 1280 procedures using mesh in the NSQIP dataset from 2010 through 2012. Procedures using mesh had a higher rate of perioperative bleeding requiring transfusion than procedures not using mesh (2.11% vs 0.60%, p < 0.001). In the 27 cases using mesh that required blood transfusion, seven transfusions occurred the same day of surgery and 10 occurred on the first post-operative day. Procedures using mesh also had a higher rate of organ surgical site infection (0.55% vs 0.18%, p < 0.05). There were no significant differences in rates of readmission, superficial or deep surgical site infections, pneumonia, urinary tract infection, sepsis, pulmonary embolism, or renal failure. The data set does not capture surgeon or site specific complications or type of kits/trocars used with the mesh. CONCLUSIONS In a review of NSQIP data, vaginal pelvic reconstruction procedures using mesh have a higher rate of perioperative bleeding requiring transfusion and organ surgical site infection than procedures not using mesh. Patients undergoing these procedures should be counselled preoperatively concerning these risks. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e1046-e1047 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Devin Haddad More articles by this author Louis Krane More articles by this author Gopal Badlani More articles by this author Majid Mirzazadeh More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...