Infectious Morbidity Risk of Laparoscopic Myomectomy Concomitant Hysteroscopy: A National Surgical Quality...

Area of Science:

• Gynecology
• Surgical Oncology
• Infectious Disease

Background:

• Laparoscopic myomectomy is a common procedure for uterine fibroids.
• Concomitant hysteroscopy is sometimes performed during laparoscopic myomectomy.
• The impact of combined procedures on surgical site infection (SSI) risk is not well-established.

Purpose of the Study:

• To evaluate if performing hysteroscopy concurrently with laparoscopic myomectomy increases the risk of surgical site infections (SSIs).
• To assess the association between combined hysteroscopy and laparoscopic myomectomy and postoperative urinary tract infection (UTI) rates.

Main Methods:

• Retrospective cohort study using the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database (2015-2023).
• Compared outcomes for patients undergoing laparoscopic myomectomy alone versus those with concomitant hysteroscopy.
• Analyzed rates of any SSI, superficial SSI, deep SSI, organ space SSI, and postoperative UTI.
• Utilized multivariate logistic regression to control for confounding variables.

Main Results:

• The addition of hysteroscopy was not significantly associated with an increased risk of any SSI (aOR 0.82; P=0.3).
• No significant differences were observed in superficial SSI, deep SSI, organ space SSI, or postoperative UTI rates between the groups.
• These findings remained consistent after adjusting for multiple patient and surgical factors.

Conclusions:

• Concomitant hysteroscopy during laparoscopic myomectomy does not significantly elevate the risk of 30-day SSIs.
• The combined procedure does not appear to increase the likelihood of postoperative UTIs.
• This suggests that performing hysteroscopy concurrently with laparoscopic myomectomy is a safe practice regarding infection risk.