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Reconstructive Surgery at Hysterectomy for Patients With Uterine Prolapse and Gynecologic Malignancy
Rasika R Deshpande1, Olivia B Foy, Rachel S Mandelbaum
1Division of Gynecologic Oncology, the Division of Reproductive Endocrinology & Infertility, and the Division of Female Pelvic Medicine & Reconstructive Surgery, Department of Obstetrics and Gynecology, the Keck School of Medicine, and the Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California; and the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University School of Medicine, New York, New York.
Abstract:
In this cross-sectional study examining 211,708 patients with a diagnosis of uterine prolapse who underwent hysterectomy between 2016 and 2019 identified in the Healthcare Cost and Utilization Project's Nationwide Ambulatory Surgery Sample, co-diagnosis of gynecologic malignancy was reported in 2,398 (1.1%) patients, and they were less likely to receive reconstructive surgery at hysterectomy (odds ratio [OR] 0.90, 95% CI 0.84-0.96). This absence of reconstructive surgery was most pronounced among patients with complete uterine prolapse and gynecologic malignancy (OR 0.68, 95% CI 0.57-0.81). The association was also consistent in coexisting gynecologic premalignancy (n=3,357 [1.6%]). In conclusion, this national-level assessment suggests that patients with uterine prolapse and coexisting gynecologic malignancy or premalignancy may be less likely to receive reconstructive surgery for pelvic floor dysfunction at hysterectomy.
