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DOI: 10.1055/s-0034-1388299
Adopting Clavien – Dindo classification of surgical complications in 438 cases of vaginal native tissue repair for pelvic organ prolapse
Objective: To analyze safety of vaginal native tissue prolapse repair using Clavien-Dindo (CD) classification of surgical complications.
Method: Data of 438 patients who underwent vaginal native tissue repair for POP between January 2009 and February 2014 were evaluated for surgical complications using the Clavien- Dindo classification. Patients were assessed before hospital discharge and at urogynecological clinic within one week.
Results: All 438 patients underwent vaginal native tissue repair for female pelvic organ prolapse. Sacrospinous fixation was performed in 269 patients, 219 patients (81%) received bilateral and 50 patients (19%) unilateral fixation. Prolapse repair was combined with hysterectomy in 255 cases (58%). One intra-operative bladder lesion (0.23%) and one rectal lesion (0.23%) occurred. Post-operative urinary tract infection requiring antibiotics was noted in 34 cases (7.8%). Post void residual volume was medically treated in 9 cases (2.1%). Four patients (0.9%) underwent post-operative supra-pubic catheter insertion. Asymptomatic gluteal hematomas were noted in 11 cases (2.5%). Four patients (0.9%) underwent re-operations for post-operative hemorrhage. Mean hospital stay was 5.6 days. Minor complications were classified as CD grade I in 2.5%, grade II in 9.9%, complications requiring surgical intervention as grade IIIa in 0.9% and as grade IIIb in 0.9% of patients. No Dindo IV or V complications occurred. Overall surgical complication rate reached 14.7%.
Conclusion: Surgery was associated with a low rate of complications. Routine insertion of supra-pubic catheters after prolapse repair does not seem to be justified. Authors suggest routine use of the CD classification for comparability of surgical methods for POP.