Clinical Edge

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Utilizing Colpopexy and Colporrhaphy

Is hysterectomy alone adequate treatment for POP?

While national guidelines consider hysterectomy along to be inadequate treatment for pelvic organ prolapse (POP), often anterior and posterior colporrhapgy are frequently performed without a colpopexy procedure and hysterectomy alone is utilized for treatment of prolapse, according to a study where POP was an indication in 1,557 hysterectomies. The study determined that colpopexy and colporrhaphy may be underutilized and are potential targets for quality improvement. Results of the analyzed hysterectomies showed:

• Use of colpopexy was independently associated with patient age >40.

• POP was the only indication for surgery (OR=1.6), laparoscopic surgery (OR=3.2), and a surgeon specializing in urogynecology (OR=8.2).

• Overall perioperative complication rate was 6.6%.

• Complications were more likely when the procedure was performed with an abdominal approach (OR=2.3), with the use of a colpopexy procedure (OR=3.1) and by a surgeon specializing in urogynecology (OR = 2.2).

Citation: Fairchild PS, Kamdar NS, Berger MB, Morgan DM. Rates of colpopexy and colporrhaphy at the time of hysterectomy for prolapse. Am J Obstet Gynecol. [Published online ahead of print September 11, 2015]. doi: 10.1016/j.ajog.2015.08.053.