Perioperative complications following colpocleisis with and without concomitant vaginal hysterectomy

Introduction and hypothesis: Pelvic organ prolapse is common in the elderly population and may be surgically treated with colpocleisis. We aimed to identify and compare surgical characteristics and 30-day perioperative complications in patients who underwent colpocleisis with and without concomitant vaginal hysterectomy (VH) using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. Methods: Women who underwent vaginal closure procedures from 2006 to 2014 were identified utilizing Current Procedural Terminology (CPT) codes for LeFort colpocleisis (57120) and vaginectomy (57110). Patients undergoing a concomitant VH were identified by CPT codes ranging from 58260 to 58294. Variables including patient demographics, operative time, hospital length of stay, transfusion‚ and reoperation were evaluated. Specific medical complications, surgical site infection‚ and urinary tract infection (UTI) rates were calculated. Variables were analyzed using chi-squared, Fisher’s exact, student’s t tests and logistic regression. Results: We identified 1,027 women in the ACS-NSQIP database who underwent vaginal closure procedures. The majority of patients (893, 87.0%) underwent colpocleisis alone, and the remainder (134, 13.0%) underwent concomitant VH. Operative times were shorter in patients undergoing colpocleisis alone. UTI was the most common postoperative complication affecting 4.3% of the entire cohort. Twelve women (1.2%) had a serious medical complication, seven who underwent colpocleisis alone and five who underwent colpocleisis with concomitant VH. In backward logistic regression‚ serious medical complications were the only variable independently associated with VH at the time of colpocleisis (p < 0.05). Conclusions: Colpocleisis is a safe procedure with rare serious adverse events.