(Poster 135) Surgical Risks in Laparoscopic Sacrocolpopexy Across BMI Groups

Objectives: This study aims to investigate the impact of body mass index (BMI) on intraoperative and postoperative complication rates in patients undergoing laparoscopic sacrocolpopexy, in order to inform surgical risk assessment and perioperative management strategies

Methods: This retrospective cohort study included women who underwent laparoscopic sacrocolpopexy for pelvic organ prolapse between 2021 and 2024. Patients were stratified into four BMI categories: normal weight (18.5–25), overweight (25–30), obese class I (30–35), and obese class II/III (>35). Data on demographics, prior surgeries, intraoperative and postoperative complications, hemoglobin change, hospital stay, and readmissions were collected. Outcomes were compared across BMI groups using appropriate statistical tests, with significance set at p< 0.05.

Results: A total of 362 patients who underwent laparoscopic sacrocolpopexy were stratified into four BMI categories. There were no significant differences between groups in terms of age, or preoperative POP-Q stage (median 3 [range 0–4]). Patients with higher BMI had a significantly greater number of prior vaginal deliveries (median 3 vs. 3 vs. 4 vs. 5, p=0.04), while rates of previous prolapse or anti-incontinence surgeries were similar. The distribution of prolapse repair types and concomitant procedures were also comparable across BMI groups. table 1
Intraoperative complication rates were low and did not differ significantly by BMI (2.6%, 1.6%, 1.1%, and 0%, p=0.86). Mean haemoglobin drop was slightly lower in overweight and obese patients but was not statistically significant (p=0.06). Median hospital stay was consistently 3 days across all groups. Rates of postoperative complications (p=0.6) and readmissions (p=0.07) showed no significant differences. However, persistent stress urinary incontinence was significantly more prevalent in patients with BMI >35 (33%) compared to lower BMI groups (6%, 6%, 10% and 33%, p=0.048) table 2

Conclusions: Laparoscopic sacrocolpopexy demonstrates a favourable safety profile across all BMI categories, with no significant differences observed in intraoperative or overall postoperative complication rates. These findings suggest that elevated BMI should not be considered a contraindication when evaluating candidates for laparoscopic prolapse repair.

Table 1. Baseline demographic and surgical characteristics of patients undergoing laparoscopic sacrocolpopexy, stratified by BMI category.
Values are presented as mean ± standard deviation, median (range), or number (percentage). POP = pelvic organ prolapse
Table 2. Intraoperative and postoperative outcomes by BMI category in patients undergoing laparoscopic sacrocolpopexy.
Values are presented as mean ± standard deviation, median (range), or number (percentage). Δ Hemoglobin = difference in hemoglobin level from pre- to post-operation; ED = emergency department; SSI = surgical site infection; UTI = urinary tract infection; SUI = stress urinary incontinence.