Impact of surgeon experience on routine prolapse operations

Area of Science:

• Urology
• Gynecology
• Surgical Outcomes Research

Background:

• Surgical experience often correlates with better outcomes in major surgeries.
• Pelvic organ prolapse (POP) surgery outcomes have not been extensively studied in relation to surgeon experience.
• A significant proportion of surgeons performing POP surgery in Sweden operate infrequently (≤ once a month).

Purpose of the Study:

• To investigate the relationship between surgeon experience and outcomes in pelvic organ prolapse (POP) surgery.
• To determine if a high number of low-volume surgeons affects the quality and success rates of POP repair.

Main Methods:

• Analysis of data from 14,676 patients undergoing primary anterior or posterior colporrhaphy.
• Logistic regression and group analysis were used to assess the impact of surgeon experience.

Main Results:

• Experienced surgeons demonstrated shorter operation times and hospital stays.
• Surgical experience did not influence complication rates, organ damage, reoperation, rehospitalization, patient satisfaction, or 1-year failure rates.
• Assistant experience also showed no effect on surgical outcomes.

Conclusions:

• A management model utilizing a high proportion of low-volume surgeons for isolated anterior or posterior POP repair is acceptable.
• The quality and outcomes of anterior or posterior colporrhaphy are not negatively impacted by a high number of low-volume surgeons.
• Surgeon experience is unlikely to be the primary reason for the observed high recurrence rates in POP surgery.