A 14-year multi-institutional collaborative study of Chinese pelvic floor surgical procedures related to pelvic organ prolapse.

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

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A 14-year multi-institutional collaborative study of Chinese pelvic floor surgical procedures related to pelvic organ prolapse.

Author: Zhi-Jing SUN ¹ ; Xiu-Qi WANG ² ; Jing-He LANG ¹ ; Tao XU ³ ; Yong-Xian LU ⁴ ; Ke-Qin HUA ⁵ ; Jin-Song HAN ⁶ ; Huai-Fang LI ⁷ ; Xiao-Wen TONG ⁷ ; Ping WANG ⁸ ; Jian-Liu WANG ⁹ ; Xin YANG ⁹ ; Xiang-Hua HUANG ¹⁰ ; Pei-Shu LIU ¹¹ ; Yan-Feng SONG ¹² ; Hang-Mei JIN ¹³ ; Jing-Yan XIE ¹⁴ ; Lu-Wen WANG ¹⁵ ; Qing-Kai WU ¹⁶ ; Jian GONG ¹⁷ ; Yan WANG ¹⁸ ; Li-Qun WANG ¹⁹ ; Zhao-Ai LI ²⁰ ; Hui-Cheng XU ²¹ ; Zhi-Jun XIA ²² ; Li-Na GU ²³ ; Qing LIU ²⁴ ; Lan ZHU ¹
Author Information

1. Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
2. Department of Obstetrics and Gynecology, Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
3. Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College, Beijing 100730, China.
4. Department of Obstetrics and Gynecology, The Fourth Medical Center, Chinese PLA General Hospital, Beijing 100048, China.
5. Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200433, China.
6. Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100083, China.
7. Department of Obstetrics and Gynecology, Tongji Hospital, Tongji University, Shanghai 200065, China.
8. Department of Obstetrics and Gynecology, West China Second Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu, Sichuan 061110, China.
9. Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China.
10. Department of Obstetrics and Gynecology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei 075100, China.
11. Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, Shandong 250002, China.
12. Department of Obstetrics and Gynecology, 900 Hospital of the Joint Logistics Team, Fuzhou, Fujian 350025, China.
13. Department of Obstetrics and Gynecology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310000, China.
14. Department of Obstetrics and Gynecology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu 210006, China.
15. Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450000, China.
16. Department of Obstetrics and Gynecology, Shanghai Jiao Tong University Sixth Hospital, Shanghai 200300, China.
17. Department of Gynecology, The Affiliated Wuxi Maternity and Child Health Care Hospital of Nanjing Medical University, Wuxi, Jiangsu 214002, China.
18. Department of Obstetrics and Gynecology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong 264000, China.
19. Department of Gynecology, Jiangxi Maternal and Child Health Hospital, Nanchang, Jiangxi 330006, China.
20. Department of Gynecology, Shanxi Maternal and Child Health Hospital, Taiyuan, Shanxi 030013, China.
21. Department of Obstetrics and Gynecology, The First Affiliated Hospital of Army Medical University (Southwest Hospital), Chongqing 400038, China.
22. Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China.
23. Department of Gynecology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 831118, China.
24. Department of Gynecology, Gansu Province Maternity and Child-care Hospital, Lanzhou, Gansu 730050, China.
Publication Type:Journal Article
MeSH: China; Female; Gynecologic Surgical Procedures/adverse effects*; Humans; Pelvic Floor/surgery*; Pelvic Organ Prolapse/surgery*; Surgical Mesh/adverse effects*; Treatment Outcome; Vagina
From: Chinese Medical Journal 2021;134(2):200-205
CountryChina
Language:English
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.