Short-Term Complications of Concomitant Pelvic Organ Prolapse and Rectal Prolapse Repair: A Systematic Review and Meta-Analysis.

Autor: Hadizadeh A; Division of Urogynecology, University of Chicago Pritzker School of Medicine, NorthShore University HealthSystem, 9650 Gross Point Road, Suite 3900, Skokie, IL, 60076, USA. ali1375hadi@gmail.com.; NorthShore University HealthSystem Research Institute, Evanston, IL, USA. ali1375hadi@gmail.com., Chill HH; Division of Urogynecology, University of Chicago Pritzker School of Medicine, NorthShore University HealthSystem, 9650 Gross Point Road, Suite 3900, Skokie, IL, 60076, USA.; Department of Obstetrics and Gynecology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel., Leffelman A; Division of Urogynecology, University of Chicago Pritzker School of Medicine, NorthShore University HealthSystem, 9650 Gross Point Road, Suite 3900, Skokie, IL, 60076, USA., Paya-Ten C; Division of Urogynecology, University of Chicago Pritzker School of Medicine, NorthShore University HealthSystem, 9650 Gross Point Road, Suite 3900, Skokie, IL, 60076, USA., Chang C; Division of Urogynecology, University of Chicago Pritzker School of Medicine, NorthShore University HealthSystem, 9650 Gross Point Road, Suite 3900, Skokie, IL, 60076, USA., Goldberg RP; Division of Urogynecology, University of Chicago Pritzker School of Medicine, NorthShore University HealthSystem, 9650 Gross Point Road, Suite 3900, Skokie, IL, 60076, USA., Abramowitch SD; Department of Bioengineering and Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, Pittsburgh, PA, USA., Rostaminia G; Division of Urogynecology, University of Chicago Pritzker School of Medicine, NorthShore University HealthSystem, 9650 Gross Point Road, Suite 3900, Skokie, IL, 60076, USA.
Jazyk: angličtina
Zdroj: International urogynecology journal [Int Urogynecol J] 2024 Dec 14. Date of Electronic Publication: 2024 Dec 14.
DOI: 10.1007/s00192-024-06007-8
Abstrakt: Introduction and Hypothesis: The objective was to evaluate and compare the short-term postoperative complications of concomitant pelvic organ prolapse (POP) and rectal prolapse repair with isolated apical prolapse repair or rectopexy.
Methods: This systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. A comprehensive literature search was performed using Web of Science, PubMed, Embase, and Scopus for studies published up to April 2024. Studies included were retrospective case-control studies, clinical cohort studies, and randomized clinical trials comparing short-term complications between concomitant apical and rectal prolapse repairs versus isolated repairs.
Results: A total of seven studies, encompassing 16,471 patients, met the inclusion criteria. Of these, 843 patients underwent concomitant surgery, 7,808 underwent apical prolapse repair alone, and 7,820 underwent rectopexy alone. The meta-analysis revealed no significant increase in the overall complication rate for the concomitant group compared with the apical prolapse alone (OR 0.78; 95% CI 0.56, 1.09; p = 0.14; I 2  = 0%) or rectopexy alone (OR 0.79; 95% CI 0.49, 1.25; p = 0.31; I 2  = 48%). Furthermore, serious complication rates were not significantly higher in the concomitant group compared with isolated apical prolapse repair (OR 0.70; 95% CI 0.43, 1.16; p = 0.16; I 2  = 0%) or rectopexy alone (OR 0.86; 95% CI 0.54, 1.35; p = 0.50; I 2  = 39%).
Conclusion: Concomitant apical and rectal prolapse repair does not significantly increase the risk of short-term postoperative complications compared with isolated repairs. This approach appears safe and feasible, suggesting that combined surgeries might offer a comprehensive treatment for patients with multicompartmental prolapse without elevating operative risks.
Competing Interests: Declarations. Conflicts of Interest: None.
(© 2024. The International Urogynecological Association.)
Databáze: MEDLINE
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