Comparison of 30-Day Complication Rate Between Minimally Invasive Hysterectomy with and Without Concomitant Urogynecologic Procedure

Abstract

Study Objective Primary objective was to evaluate risk of perioperative complications when performing concomitant urogynecologic surgery at time of minimally invasive hysterectomy for large uterus (>250gm). Design Retrospective cohort study of existing national database. Patients were followed for complications 30 days after hysterectomy. Setting Data was extracted from the NSQIP database. Patients or Participants Patients were included who underwent laparoscopic or vaginal hysterectomy for benign indications with uterine weight of at least 250gm from 2014-2017. Patients with gynecologic malignancy and those who underwent abdominal hysterectomy were excluded. The total cohort included 7,428 patients. Interventions We assessed the effect of concomitant urogynecologic procedure on 30 day complication rates after laparoscopic or vaginal hysterectomy for large uterus (>250gm). Measurements and Main Results Chi-square analysis and Student s t-test were used to describe the population and compare groups. Primary outcome was composite rate of all 30 day complications. Stepwise backward multivariate logistic regression was used to control for confounders of the primary outcome. 301 of the 7,428 total patients (4.1%) underwent concomitant urogynecologic procedures. This population was older (49.7 vs 46.6 years, p Conclusion In this retrospective analysis of a large national cohort, the 30 day complication rate was greater than 50% higher when concomitant urogynecologic procedure was performed at the time of minimally invasive hysterectomy for a uterus >250gm.