Change over time in the surgical management of pelvic organ prolapse between 2008 and 2014 in France: patient profiles,
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ORIGINAL ARTICLE
Change over time in the surgical management of pelvic organ prolapse between 2008 and 2014 in France: patient profiles, surgical approaches, and outcomes Mathilde Hendriks 1,2
&
Stéphanie Bartolo 3,4 & Géraldine Giraudet 1 & Michel Cosson 1,5 & Emmanuel Chazard 4
Received: 14 March 2020 / Accepted: 3 August 2020 # The International Urogynecological Association 2020
Abstract Introduction and hypothesis Pelvic organ prolapse (POP) is a common pathological condition that may require surgical management. Several surgical treatment options are possible, and practice varies from one center to another. The objective of the present study was to describe the surgical management and outcomes of POP in France from 2008 to 2014. Methods We performed a retrospective cohort study of all patients operated on for POP from 2008 to 2014, according to the French national hospital discharge summary database. Patient characteristics, surgical approaches, concomitant hysterectomy and/or incontinence surgery, the length of stay, the proportion of day-case operations, and patient outcomes were analyzed. Results We analyzed 310,938 hospital stays with POP surgery between 2008 and 2014; 130,908 (42%) of the operations took place in hospitals performing more than 100 prolapse surgical procedures per year. The proportion of day-case operations was low, but rose significantly from 1.2% to 4.6% during the study period. More than half of the operations featured a vaginal approach. The proportions of operations with concomitant hysterectomy or urinary incontinence surgery fell from 41.0% to 36.1% and from 33.0% to 25.8% respectively. The proportions of laparoscopic procedures increased. The mortality rate was stable (0.07% for all years). Conclusions The number of patients undergoing POP surgery remained stable from 2008 to 2014. The proportion of laparoscopic procedures increased (in parallel with the rising proportion of day-case operations) and the proportion of procedures with concomitant hysterectomy or incontinence treatment decreased. Keywords Pelvic organ prolapse . Hysterectomy . Urinary incontinence
Introduction
* Mathilde Hendriks [email protected] 1
CHU Lille, Pôle Femme Mère Nouveau-né, Université de Lille, Avenue Eugène Avinée, 59000 Lille, France
2
Hôpital Jeanne de Flandre, Faculté de Médecine, Université de Lille France, 1 rue Eugène Avinée, 59045 Lille cedex, France
3
Douai Hospital, Gynecology-Obstetric Unit, route de Cambrai, BP10740, 59507 Douai cedex, France
4
CHU Lille, ULR 2694—METRICS: Évaluation des technologies de santé et des pratiques médicales, Université de Lille, 59000 Lille, France
5
Laboratoire de Mécanique de Lille – UMR CNRS 8107, 59000 Lille, France
Pelvic organ prolapse (POP) is a common pathological condition. The prevalence of self-reported POP ranges from 2.9% to 11.4% [1], and the prevalence of POP upon clinical examination ranges from 31.8% to 97.7% [1]. The main treatment option for POP is surgery [2]. In France, 11% of women over the age of 70 have been oper
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