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Postoperative appointments: which ones count?

Margaret G Mueller1,2, Dana Elborno3, Bhumy A Davé4

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Summary
This summary is machine-generated.

Most reconstructive pelvic surgery complications occur within two weeks, with infections and retention being common early issues. Later complications, particularly those involving mesh or sutures, are often identified by the 13-week postoperative visit.

Keywords:
Pelvic floor disordersPostoperative complicationsReconstructive pelvic surgeryUrogynecology

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Area of Science:

  • Urogynecology
  • Pelvic Reconstructive Surgery
  • Surgical Outcomes

Background:

  • Postoperative complications following reconstructive pelvic surgery (RPS) are known but their temporal occurrence is not well-defined.
  • Understanding the timeline of complications is crucial for optimizing postoperative care and visit scheduling.

Purpose of the Study:

  • To determine the timeframe during which the majority of complications arise after reconstructive pelvic surgery (RPS).
  • To inform the planning of postoperative follow-up intervals for patients undergoing RPS.

Main Methods:

  • Retrospective review of billing information to identify women who underwent RPS.
  • Extraction of demographic, surgical, and complication data from electronic medical records.
  • Application of the Pelvic Floor Complication scale at 2, 6, and 13-week postoperative visits.

Main Results:

  • Of 396 women, 125 experienced 179 complications, with 66% identified by the 2-week visit.
  • Early complications (by 2 weeks) included urinary tract infection (46%), wound infection (10%), and urinary retention (9.4%).
  • Serious complications like VTE, ileus, SBO, readmission, and reoperation were mostly diagnosed within 2 weeks; later complications (6-13 weeks) were often mesh/suture-related.

Conclusions:

  • The majority of non-mesh/suture complications after RPS manifest within the initial two weeks.
  • Complications related to mesh and sutures are more frequently detected at the later 13-week postoperative assessment.