(Poster 116) Perioperative Outcomes in Patients 75 and Older: A Retrospective Review

Objectives: Our objective is to determine the rate of perioperative complications in those undergoing prolapse repair procedures who are aged 75 and older, in comparison to those who have previously been studied at our university, who have undergone similar prolapse repair procedures. Due to perceived increased risk of perioperative complications in the age group of 75 years plus, a knowledge gap exists in studies comparing complication rates within this group. Our aim is to determine if pelvic organ prolapse repair in patients greater than age 75 has comparable perioperative outcomes to those patient cohorts who have undergone similar prolapse procedures.

Methods: At Banner University Medical Center- Tucson, we have collected a database of 460 patients who haveu ndergone one of the following procedures: laparoscopic sacrocolpopexy, laparoscopic pectopexy, laparoscopic USLS, SSLF and colpocleisis. A retrospective chart review of patietn data from these procedures from October 2014 to January 2024 was performed. All surgeries performed at Banner University Medical Center- Tucson by three surgeons. All patients were evaluated in clinic prior to their operation and level of prolapse quantified. The patients were followed immediately post operatively to asses for perioperative complications until their follow up visit. Major complications are defined as cystotomy, enterotomy, mesh erosion, small bowel obstruction, pulmonary emboli, deep vein thrombosis, surgical site infection, and readmission. Other complications included hematoma formation, prolapse reoperation, urinary retention requiring intervention. P values are calculated from Student's t tests for continuous variables.

Results: Of the 460 patients who underwent laparoscopic sacrocolopexy, laparoscopic pectopexy, USLS, SSLF, and colpocleisis, 32 patients were identified to have undergone surgery at or above the age of 75 from 2021-2023. We compared the age 75 and above cohort to three different cohorts of previously studied patients who underwent laparoscopic sacrocolpopexy, laparoscopic USLS, and SSLF. On preliminary analysis, we found the 75 years old and above group to have a complication rate of 6.25% (SD 0.24). The laparoscopic sacrocolpopexy group was found to have a complication rate of 9.7% (SD 0.30, p< 0.05). The L-USLS complication rate was 10.62% (SD 0.31, p< 0.07) and SSLF complication rate was 14.68% (SD 0.36, p< 0.009)

Conclusions: Our preliminary analysis suggest that pelvic organ prolapse surgery in patients at and above 75 years old has comparable rates of perioperative complications when compared to patients undergoing laparoscopic sacrocolpopexy, laparoscopic USLS, and SSLF. Patients at or above 75 had statistically significant fewer number of complications than the SSLF group. Patients in the 75 and older group had the following major complications: 1 readmission for pulmonary embolism, and 1 patient with urinary retention requiring intervention. 47% of patients in the above 75 age group underwent laparoscopic pectopexy, as this approach was deemed safest by the surgeon.