A 14-year multi-institutional collaborative study of Chinese pelvic floor surgical procedures related to pelvic organ prolapse

Zhi-Jing Sun, Xiu-Qi Wang, Jing-He Lang, Tao Xu, Yong-Xian Lu, Ke-Qin Hua, Jin-Song Han, Huai-Fang Li, Xiao-Wen Tong, Ping Wang, Jian-Liu Wang, Xin Yang, Xiang-Hua Huang, Pei-Shu Liu, Yan-Feng Song, Hang-Mei Jin, Jing-Yan Xie, Lu-Wen Wang, Qing-Kai Wu, Jian Gong, Yan Wang, Li-Qun Wang, Zhao-Ai Li, Hui-Cheng Xu, Zhi-Jun Xia, Li-Na Gu, Qing Liu, Lan Zhu, Zhi-Jing Sun, Xiu-Qi Wang, Jing-He Lang, Tao Xu, Yong-Xian Lu, Ke-Qin Hua, Jin-Song Han, Huai-Fang Li, Xiao-Wen Tong, Ping Wang, Jian-Liu Wang, Xin Yang, Xiang-Hua Huang, Pei-Shu Liu, Yan-Feng Song, Hang-Mei Jin, Jing-Yan Xie, Lu-Wen Wang, Qing-Kai Wu, Jian Gong, Yan Wang, Li-Qun Wang, Zhao-Ai Li, Hui-Cheng Xu, Zhi-Jun Xia, Li-Na Gu, Qing Liu, Lan Zhu

Abstract

Background: It has been a global trend that increasing complications related to pelvic floor surgeries have been reported over time. The current study aimed to outline the development of Chinese pelvic floor surgeries related to pelvic organ prolapse (POP) over the past 14 years and investigate the potential influence of enhanced monitoring conducted by the Chinese Association of Urogynecology since 2011.

Methods: A total of 44,594 women with POP who underwent pelvic floor surgeries between October 1, 2004 and September 30, 2018 were included from 22 tertiary academic medical centers. The data were reported voluntarily and obtained from a database. We compared the proportion of each procedure in the 7 years before and 7 years after September 30, 2011. The data were analyzed by performing Z test (one-sided).

Results: The number of different procedures during October 1, 2011-September 30, 2018 was more than twice that during October 1, 2004-September 30, 2011. Regarding pelvic floor surgeries related to POP, the rate of synthetic mesh procedures increased from 38.1% (5298/13,906) during October 1, 2004-September 30, 2011 to 46.0% (14,107/30,688) during October 1, 2011-September 30, 2018, whereas the rate of non-mesh procedures decreased from 61.9% (8608/13,906) to 54.0% (16,581/30,688) (Z = 15.53, P < 0.001). Regarding synthetic mesh surgeries related to POP, the rates of transvaginal placement of surgical mesh (TVM) procedures decreased from 94.1% (4983/5298) to 82.2% (11,603/14,107) (Z = 20.79, P < 0.001), but the rate of laparoscopic sacrocolpopexy (LSC) procedures increased from 5.9% (315/5298) to 17.8% (2504/14,107).

Conclusions: The rate of synthetic mesh procedures increased while that of non-mesh procedures decreased significantly. The rate of TVM procedures decreased while the rate of LSC procedures increased significantly.

Trial registration number: NCT03620565, https://register.clinicaltrials.gov.

Conflict of interest statement

None.

Copyright © 2020 The Chinese Medical Association, produced by Wolters Kluwer, Inc. under the CC-BY-NC-ND license.

Figures

Figure 1
Figure 1
Proportions of TVM and LSC among synthetic mesh surgeries related to POP each year. LSC: Laparoscopic sacrocolpopexy; POP: Pelvic organ prolapse; TVM: Transvaginal placement of surgical mesh.

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Source: PubMed

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