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A 14-year multi-institutional collaborative study of Chinese pelvic floor surgical procedures related to pelvic organ prolapse
Authors: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.
Keywords:Laparoscopic sacrocolpopexy  Pelvic organ prolapse  Synthetic mesh  Transvaginal placement of surgical mesh
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