Transfusion Rates and the Utility of Type and Screen for Pelvic Organ Prolapse Surgery

Area of Science:

• Urogynecology
• Surgical Outcomes
• Blood Transfusion Management

Background:

• Limited data compare blood transfusion rates across different apical pelvic organ prolapse (POP) surgical routes.
• Evidence is scarce regarding the necessity of preoperative type and screen (T&S) for apical POP surgery.

Purpose of the Study:

• To compare perioperative blood transfusion rates among abdominal, robotic, and vaginal apical POP surgery routes.
• To determine the incidence of positive preoperative antibody screens in women undergoing apical POP surgery.

Main Methods:

• Retrospective cohort study involving 610 women undergoing apical POP surgery.
• Surgical routes included abdominal sacrocolpopexy, robotic sacrocolpopexy, and vaginal ligament fixation.
• Analysis of perioperative blood transfusion and preoperative antibody screen results.

Main Results:

• A total of 3.9% of patients received perioperative blood transfusions.
• Abdominal surgery had a significantly higher transfusion rate (11.1%) compared to robotic (0.5%) and vaginal (0.5%) routes (P < 0.001).
• The rate of positive preoperative antibody screens was low (1.5% among 572 tested).

Conclusions:

• Abdominal apical POP surgery is associated with a significantly higher risk of blood transfusion.
• The low rate of positive antibody screens suggests that using type O blood may be a low-risk alternative when cross-matched blood is unavailable.
• Omitting preoperative type and screen before robotic or vaginal apical POP surgery may be a reasonable approach.