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Healthcare Resource Utilization Following Minimally Invasive Sacrocolpopexy: Impact of Concomitant Rectopexy
Lannah L Lua-Mailland1, Elizabeth E Stanley2, Meng Yao3
1Section of Urogynecology and Reconstructive Pelvic Surgery, Obstetrics and Gynecology Institute, 9500 Euclid Avenue, A81, Cleveland, OH, 44195, USA. lual@ccf.org.
International Urogynecology Journal
|February 28, 2024
Summary
Adding rectopexy (RP) to sacrocolpopexy (SCP) surgery for pelvic organ prolapse does not increase healthcare resource utilization. This study found no difference in unscheduled visits or readmissions within six weeks for patients undergoing combined SCP-RP versus SCP alone.
Area of Science:
- Urogynecology
- Minimally Invasive Surgery
- Pelvic Organ Prolapse
Background:
- Combined surgical procedures, including sacrocolpopexy (SCP) and rectopexy (RP), are increasingly used for multicompartment pelvic organ prolapse.
- Healthcare resource utilization (HRU) following these combined procedures requires further investigation.
Purpose of the Study:
- To compare HRU within six weeks after combined SCP and RP surgery versus SCP alone.
- To test the hypothesis that concomitant RP does not impact postoperative HRU.
Main Methods:
- A retrospective cohort study analyzed data from 549 patients undergoing minimally invasive SCP between 2017 and 2022.
- Patients were categorized into two groups: those who underwent concomitant RP (SCP-RP) and those who had SCP alone (SCP-only).
- HRU was defined as unscheduled office visits, emergency department visits, or readmissions within six weeks post-surgery. Multivariable regression identified factors associated with HRU.
Main Results:
- Of 549 patients, 183 (33.3%) experienced at least one HRU encounter within six weeks.
- No significant difference in composite HRU was observed between the SCP-RP group (34.0%) and the SCP-only group (33.1%; p=0.84).
- Common reasons for HRU included pain, urinary tract infection symptoms, and wound issues. Concomitant mid-urethral sling increased HRU risk twofold.
Conclusions:
- Approximately one-third of patients undergoing minimally invasive SCP experience an unanticipated healthcare encounter within six weeks post-surgery.
- Concomitant rectopexy in addition to sacrocolpopexy does not lead to increased postoperative healthcare resource utilization.
