Outcomes of cystocele repair surgery in relation to different anesthesia methods

• Published in: Acta obstetricia et gynecologica Scandinavica Vol. 89; no. 7; pp. 876 - 881
• Main Authors: Pakbaz, Mojgan, Mogren, Ingrid, Löfgren, Mats
• Format: Journal Article
• Language: English
• Published: Oxford, UK Informa UK Ltd 01.07.2010; Blackwell Publishing Ltd; Blackwell
• Subjects: Aged; Analysis of Variance; Anesthesia; Anesthesia Recovery Period; Anesthesia, General - adverse effects; Anesthesia, General - methods; Anesthesia, Local - adverse effects; Anesthesia, Local - methods; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Cross-Sectional Studies; Cystocele; Cystocele - diagnosis; Cystocele - surgery; Female; General anesthesia. Technics. Complications. Neuromuscular blocking. Premedication. Surgical preparation. Sedation; Gynecology. Andrology. Obstetrics; Humans; Kirurgi; Length of Stay; Logistic Models; Medical sciences; MEDICIN; MEDICINE; Middle Aged; Multivariate Analysis; national register; Nephrology. Urinary tract diseases; Obstetrics and gynaecology; Obstetrics and women's diseases; Obstetrik och gynekologi; Obstetrik och kvinnosjukdomar; Pain Measurement; Patient Satisfaction; Probability; Registries; Retrospective Studies; Risk Assessment; Severity of Illness Index; Surgery; Treatment Outcome; Urinary system involvement in other diseases. Miscellaneous; Urinary tract. Prostate gland; Urologic Surgical Procedures - methods; Human; Urinary system disease; Prognosis; Gynecology; Satisfaction; national register; Urinary tract disease; Method; Obstetrics; patient satisfaction; Cystocele; Treatment; Register; Surgery; Anesthesia; Bladder disease; Repair
• ISSN: 0001-6349; 1600-0412; 1600-0412
• DOI: 10.3109/00016349.2010.487515

Abstract Objective. To investigate outcomes of cystocele surgery by different anesthesia and evaluation of patient satisfaction. Design. Population-based, retrospective study. Setting. All clinics that included patients in the Swedish National Register for Gynecological Surgery. Population. A total of 1,364 women who underwent cystocele repair from January 2006 to June 2009. Methods. The study population was retrieved from the Register among women who had surgery and where there was complete information on concurrently used anesthesia. Clinical variables were compared. Peri- and postoperative complications were investigated. Multivariate logistic regression analysis was applied to identify independent factors for patient satisfaction. Main outcome measures. Time to recovery, complications and patient satisfaction. Results. We found a wide variation between hospitals with respect to use of local anesthesia (LA) in cystocele surgery. Length of hospital stay, duration of use of postoperative painkilling drugs, and patient-reported time to return to daily activity were shorter in the LA group compared to the other two anesthesia forms. Postoperative complications did not differ between groups. Age (≥50 years) and patient-reported complications were independent factors related to patient satisfaction (OR 3.05; 95%CI 1.36-6.82 and OR 0.21; 95%CI 0.12-0.36, respectively). Patient satisfaction did not relate to methods of anesthesia. Conclusion. Cystocele surgery can be performed safely using LA thus limiting the use of more invasive anesthesia methods. LA benefits patients and should be increasingly used.