Related Experiment Video
Updated: Mar 17, 2026
Laparoscopic Anterior Right Hepatectomy: A Single-Center Experience
Published on: December 4, 2023
HbA1c as a Predictor of Complications in Anterior and Posterior Colporrhaphy
Alexandra McQuillen1, Vaishnavi J Patel2, Devki Patel3
1Department of Research, Philadelphia College of Osteopathic Medicine, Philadelphia, USA.
Insights
Patients with higher HbA1c levels (≥6.5) undergoing colporrhaphy face three times the odds of surgical complications. Strict glycemic control is recommended to mitigate these risks in diabetic patients.
Area of Science:
- Urogynecology
- Surgical Outcomes
- Diabetes Management
Background:
- Colporrhaphy is a surgical treatment for vaginal prolapse with a known high complication rate.
- Individuals with diabetes mellitus often experience increased complications in various urological surgeries, particularly those involving mesh or prosthesis.
Purpose of the Study:
- To investigate the association between glycated hemoglobin (HbA1c) levels and the occurrence of complications following anterior or posterior colporrhaphy.
Main Methods:
- A retrospective review of 182 patients who underwent anterior or posterior colporrhaphy was conducted using the 2021 National Surgical Quality Improvement Program database.
- Patients were stratified based on HbA1c levels: ≤6.4% and ≥6.5%.
- A 30-day composite of major and minor complications was analyzed, with multivariate logistic regression used to identify predictors of complications.
Main Results:
- The cohort with HbA1c ≥6.5 (n=46) exhibited a higher composite complication rate (21.7%) compared to the HbA1c ≤6.4 group (10.3%, n=136).
- Urinary tract infection was the most frequent complication (8.2%).
- Adjusted analysis revealed that patients with HbA1c ≥6.5 had significantly higher odds of experiencing complications (OR 3.16, p=0.05).
Conclusions:
- Diabetes, indicated by elevated HbA1c levels, should be recognized as a significant comorbidity in patients undergoing colporrhaphy.
- Higher HbA1c levels are associated with a threefold increased risk of surgical complications after colporrhaphy.
- Implementing strict glycemic control in diabetic patients is crucial for reducing complication rates during and after colporrhaphy procedures.
Importance:
Colporrhaphy is a surgical option for anterior or posterior compartment vaginal prolapse. Colporrhaphy has a high complication rate. Previous literature proved that individuals diagnosed with diabetes had higher rates of complications in other urological surgeries, especially in prosthesis or mesh insertion.
Objective:
This study aims to determine if HbA1c is associated with anterior or posterior colporrhaphy complications.
Study Design:
The 2021 National Surgical Quality Surgical Improvement database was used for a retrospective review study of patients who had anterior or posterior colporrhaphy. The cohort was subdivided into those with HbA1c ≤6.4 and those with ≥6.5. In a 30-day composite, major and minor complications were analyzed. A multivariate logistic regression was then performed to predict complications.
Results:
A total of 182 patients were included, with 46 (25.3%) in the ≥6.5 cohort and 136 (74.7%) in the ≤6.4 cohort. The ≥6.5 group was older (67.9 years vs. 64.1 years), whereas there was no noted difference in race, hypertension, or previous abdominal operations. The composite complication was higher in the ≥6.5 group at 21.7% (n = 10) compared to 10.3% (n = 14) in the ≤6.4 group. The most common complication was urinary tract infection (8.2%, n = 15). On adjusted analysis, the ≥6.5 group had higher odds of complication (OR 3.16, p = 0.05).
Conclusions:
Diabetes should be considered a comorbidity in patients undergoing anterior or posterior colporrhaphy. Our study shows that there are three times the odds of complications in patients with higher HbA1c. Strict glycemic control should be implemented to decrease the risk.
