Handa Victoria L, Harvey Lynn, Cundiff Geoffrey W, Kjerulff Kristen H
Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland 21224-2780, USA.
Urology. 2005 Mar;65(3):483-7. doi: 10.1016/j.urology.2004.10.022.
To establish whether the short-term risks of prolapse surgery are increased by a concomitant anti-incontinence procedure.
Using data from the past 4 years of the National Hospital Discharge Survey, we identified women admitted for surgery for pelvic organ prolapse (specifically, suspension of the vagina or obliteration of the cul-de-sac, with or without concomitant hysterectomy or vaginal repairs). We identified women diagnosed with complications (including infections, bleeding complications, surgical injuries, pulmonary complications, and cardiovascular complications). We used multiple logistic regression analysis to compare women with and without complications with respect to concurrent continence procedures, controlling for demographic characteristics, concurrent procedures, and medical comorbidity (using the Charlson index).
Of the 1931 women who underwent prolapse surgery, concomitant anti-incontinence procedures were performed in 514 (26.6%). Complications were reported in 288 patients (14.9%) and were associated with medical comorbidity (odds ratio 11.2) and concomitant hysterectomy (odds ratio 1.5). Concomitant surgery for incontinence was not associated with an increased risk of complications.
These data suggest that medical comorbidity is strongly associated with complications after surgery for pelvic organ prolapse. A concomitant anti-incontinence procedure did not significantly increase the immediate morbidity of prolapse surgery.
确定同时进行抗尿失禁手术是否会增加脱垂手术的短期风险。
利用国家医院出院调查过去4年的数据，我们确定了因盆腔器官脱垂接受手术的女性（具体为阴道悬吊术或后穹窿封闭术，伴或不伴子宫切除术或阴道修复术）。我们确定了被诊断患有并发症（包括感染、出血并发症、手术损伤、肺部并发症和心血管并发症）的女性。我们使用多因素逻辑回归分析，在控制人口统计学特征、同期手术和医疗合并症（使用查尔森指数）的情况下，比较有无并发症的女性在同期进行尿失禁手术方面的情况。
在1931例行脱垂手术的女性中，514例（26.6%）同时进行了抗尿失禁手术。288例患者（14.9%）报告有并发症，并发症与医疗合并症（比值比11.2）和同期子宫切除术（比值比1.5）相关。同期进行尿失禁手术与并发症风险增加无关。
这些数据表明，医疗合并症与盆腔器官脱垂手术后的并发症密切相关。同时进行抗尿失禁手术并未显著增加脱垂手术的近期发病率。
