Laparoscopic sacrocolpopexy is as safe in septuagenarians or elder as in younger women

• Published in: Gynecological surgery Vol. 15; no. 1; pp. 1 - 10
• Main Authors: Vossaert, Karlien, Housmans, Susanne, Pacquée, Stefaan, Callewaert, Geertje, Cattani, Laura, Van der Aa, Frank, Wolthuis, Albert, D’hoore, André, Roelandt, Philip, Deprest, Jan
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.12.2018; Springer Nature B.V
• Subjects: Gynecology; Interventional Radiology; Laparoscopy; Medicine; Medicine & Public Health; Minimally Invasive Surgery; Obstetrics/Perinatology/Midwifery; Older people; Original Article; Reproductive Medicine; Surgical Oncology; Womens health; Laparoscopic sacropexy; Complication; Laparoscopy; Elder women; Elderly; Conversion
• ISSN: 1613-2076; 1613-2084
• DOI: 10.1186/s10397-018-1043-7

Background Data concerning laparoscopic sacrocolpopexy (LSCP) in elder women are scarce. We compared intra-operative and early-postoperative complications associated with laparoscopic colpo-, cervico-, or hysteropexy in women under and above 70 years. Methods Retrospective assessment by an independent investigator of a prospective cohort of 571 consecutive women undergoing LSCP in a tertiary unit over an 18-year period. Data included were patient demographics, operative variables, intra-operative, and early (≤ 3 months) postoperative complications. Complications were graded according to the Clavien-Dindo classification and mesh complications categorized using the International Urogynaecological Association (IUGA)-classification. Findings Median age was 66 (IQR 15, range 27-91) and 204 (35.7%) patients were older than 70 years. There were no deaths. Strategic conversion rate was 2.3% (13/571), the majority because of extensive adhesions yet early in our experience. Reactive conversion rate was 0.7% (4/571). Among 554 patients who had a completed LSCP, there were 20 intra-operative complications (3.6%), mostly bladder (1.3%) and vaginal (1.1%) injuries. Eighty-four patients had a total of 95 early-postoperative Dindo ≥ II complications (15.1%). Most common complications were infectious and treated medically (Dindo II). Clinically major complications are rare (III = 3.1% and IV = 0.2%). Reoperation for suspected bleeding (IIIb = 0.7%) was the most common reintervention, typically without demonstrable cause. Most mesh complications were vaginal exposures. Septuagenarians were not more likely to have an intra-operative (4.0 vs 3.3% < 70 years, p  = 0.686) or early-postoperative complication (13.6 vs 16.0% < 70 years, p  = 0.455) than younger patients. Mesh complications were also equally uncommon. Conclusions LSCP is as well-tolerated by women above 70 years as by younger women.