Perioperative gastrointestinal complications after abdominal and intraperitoneal vaginal surgery for pelvic organ prolapse

Objective: The purpose of this study was to compare the incidence of perioperative gastrointestinal complications following sacral colpopexy and vaginal vault suspension for pelvic organ prolapse. Design: This is a retrospective study of patients who experienced gastrointestinal complications following abdominal sacral colpopexy and intraperitoneal vaginal vault suspension. Methods: All subjects treated with abdominal sacral colpopexy and intraperitoneal vaginal vault suspension during a 36-month period were compared retrospectively. Gastrointestinal complications including intraoperative bowel injury and postoperative ileus and small bowel obstruction were identified using International Classification of Diseases, 9th revision (ICD-9) codes, and confirmed with the electronic medical record. Results: Ninety-seven subjects treated with sacral colpopexy were compared to 422 subjects treated with vaginal vault suspension. The incidence of intraoperative bowel complications was greater with sacral colpopexy than with vaginal vault suspension (2/97 [2.1% 95% CI 0.1-7.7] versus 0/422 [0.0% 95% CI 0-1.1], p=0.04). Postoperative gastrointestinal complications were also greater in the sacral colpopexy group (4/97 [4.1% 95% CI 2.6-12.3] versus 2/422 [0.47% 95% CI .01-1.8], p=0.01). After controlling for confounders, subjects treated with sacral colpopexy had a significantly greater risk (adjusted OR 13.9 [95% CI 1.7-161], p=0.01) of all perioperative gastrointestinal complications. Conclusions: Surgery for vault prolapse by sacral colpopexy is associated with a significantly higher risk of developing perioperative gastrointestinal complications than is intraperitoneal vaginal vault suspension. © Copyright 2011, Mary Ann Liebert, Inc.

Duke Scholars

Author Matthew Don Barber Obstetrics and Gynecology

Author John E Jelovsek Obstetrics and Gynecology, Urogynecology