Concomitant Repair of Pelvic Floor Disorders in Women Undergoing Surgery for Gynecologic Malignancies

Bochenska, Katarzyna; Mueller, Margaret; Geynisman‐Tan, Julia; Leader-Cramer, A.; Dave, B.; Lewicky-Gaupp, Christina; Kenton, Kimberly

doi:10.1097/spv.0000000000000579

Cited by 13 publications

(24 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Furthermore, they found that these combination cases had a low but statistically significant increase in postoperative adverse events [8,9]. Previous studies have reported the incidence of major postoperative complications for combination urogynecologic and gynecologic cancer surgery has been found to be at a rate of 8.2%, which is similar to the major postoperative complication incidence rate of 9.8% in patients undergoing surgery for gynecologic cancers only [8,10].…”

Section: Introductionmentioning

confidence: 71%

Perioperative Outcomes of Combined Gynecologic Oncology and Urogynecologic Surgeries

Eddib¹,

Eddib²,

Fan³

2020

JSO

View full text Add to dashboard Cite

Background: Many women diagnosed with a gynecologic malignancy may have coinciding urogynecologic complaints, such as pelvic organ prolapse (POP) and/or urinary incontinence, with approximately 35% reporting moderate to severe symptoms. Recent National Surgical Quality Improvement Program (NSQIP) database inquiries of gynecologic cancer cases found only 2.3-2.4% of women undergoing interventional surgery for gynecologic malignancy also had a procedure for pelvic organ prolapse urinary incontinence (POPUI), and those combination cases did not show significant increase in postoperative risks. The purpose of our study is to review our cases of gynecologic cancer that underwent concomitant urogynecologic procedures and compare their perioperative outcomes to gynecologic cancer cases without concomitant urogynecologic procedures. Methods: A retrospective cohort study conducted at a teaching hospital included 29 gynecologic oncology patients who underwent robot-assisted total laparoscopic hysterectomy, bilateral salpingo-oophorectomy, and lymphadenectomy. Controls underwent standard staging procedure and were compared to women with concomitant pelvic floor dysfunction that underwent additional laparoscopic uterosacral ligament suspension for apical suspension and a sling for stress urinary incontinence (SUI). The primary outcome was operative time, defined as documented total operative time and robot console time. Secondary outcomes include delta hemoglobin, hospital length of stay, readmission rate, total pain medication, urinary retention and discharge with foley. Results: The combined case group had longer total procedure time duration (301 minutes versus 210 minutes, p-value < 0.0001), with comparable mean console time (178 minutes versus 160 minutes; p = 0.1456). Blood loss estimated by mean percent difference of Hgb showed moderate conditional dependence on surgical case (22.2% cases versus 14.9% controls, p-value 0.04). Combined cases resulted in 76.9% of subjects discharged with a foley catheter compared to none in controls (p-value < 0.0001). Otherwise, there was no difference in the other perioperative outcomes between the two groups. Conclusion: With appropriate counseling and clinical judgement, combined urogynecologic and gynecologic oncologic surgeries can be performed to improve a patient’s quality of life (QOL) with minimal increase in perioperative morbidity.

show abstract

Section: Introductionmentioning

confidence: 71%

Perioperative Outcomes of Combined Gynecologic Oncology and Urogynecologic Surgeries

Eddib¹,

Eddib²,

Fan³

2020

JSO

View full text Add to dashboard Cite

show abstract

“…In the general female population, urinary incontinence problems affect approximately 30% (5–70%) [ 35 ], whereas 51–59% in patients before oncological treatment [ 17 , 19 ].…”

Section: Resultsmentioning

confidence: 99%

“…The treatment of reproductive organ statics abnormalities during oncologic treatment is not popular. An assessment of this issue is presented in the work of Bochenska et al [ 35 ], who studied 23,501 women treated for gynecologic cancers between 2010 and 2014. Data were obtained from available surgical registries of the American College of Surgeons National Surgical Quality Improvement Program.…”

Section: Resultsmentioning

confidence: 99%

“…We noticed that treatment options for pelvic floor dysfunction following oncological treatment for endometrial cancer is very rarely the subject of research. The discussed studies describe promising results of oncological procedures with concomitant urogynecological surgery in patients diagnosed with urinary incontinence or pelvic organ prolapse prior to surgery [ 15 , 35 ]. We did not find any papers on management of urogynecologic disorders after completing the course of oncological treatment, this might be explained by rare urogynecological follow-up after endometrial cancer treatment, which leads to underdiagnosing pelvic floor disorders and lack of implementing adequate prophylaxis and treatment for EC survivors dealing with urinary incontinence or pelvic organ prolapse.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Functional Changes of the Genitourinary and Gastrointestinal Systems before and after the Treatment of Endometrial Cancer—A Systematic Review

Opławski

Średnicka²,

Dutka³

et al. 2021

JCM

View full text Add to dashboard Cite

The incidence of endometrial cancer (EC), which coexists with such civilization diseases as diabetes, obesity or hypertension, is constantly increasing. Treatment includes surgery as well as brachytherapy, teletherapy, rarely chemotherapy or hormone therapy. Due to the good results of the treatment, the occurrence of side effects of therapy becomes a problem for the patients. One of the large groups of side effects includes the pelvic organ prolapse, urinary and fecal incontinence. The aim of this study was to present current knowledge on the occurrence of pelvic floor dysfunction in women treated for EC. A literature review was conducted in the PubMED and WoS databases, including articles on pelvic floor dysfunction in women with EC. PRISMA principles were followed in the research methodology. A total of 1361 publications were retrieved. Based on the inclusion and exclusion criteria, 24 papers were eligible for the review. Mostly retrospective studies based on different questionnaires were evaluated. No prospective studies were found in which, in addition to subjective assessment, clinical examination and objective assessment of urinary incontinence were used. Studies show a significant increase in the incidence of pelvic floor disorders, including urinary incontinence, after various forms of EC treatment. We believe that assessment of complications after endometrial cancer treatment is clinically relevant. The review emphasizes the importance of programming prospective studies to prevent and address these disorders at each stage of oncologic treatment.

show abstract

“…Many survivors of gynecologic malignancies have pelvic floor disorders and often have these symptoms before their oncologic treatment. Prior literature shows 53.1–59.5% 1,2 of women with gynecologic malignancies have stress urinary incontinence and 10.9% have symptomatic pelvic organ prolapse 3 . With a 20% lifetime risk of having pelvic floor reconstruction by the age of 80 years, there are many opportunities for surgical collaboration 4 .…”

mentioning

confidence: 99%

Surgeon Attitudes Toward Concurrent Urogynecologic and Gynecologic Oncology Procedures: A Cross-sectional Survey

Lai¹,

Goldberg

Shalom³

2022

Female Pelvic Med Reconstr Surg

View full text Add to dashboard Cite

ImportanceThere is increasing overlap in the urogynecologic and gynecologic oncologic patient populations. To improve patient advocacy and access to care, a collaborative surgical approach may benefit this cohort.ObjectiveThe aim of the study was to evaluate surgeon attitudes toward performing concurrent urogynecologic and gynecologic oncology procedures. We hypothesized that most surgeons are amenable to collaboration.Study DesignWe conducted a cross-sectional questionnaire of members of the Society of Gynecologic Oncology and the American Urogynecologic Society from August to November 2020. A 23-item online survey was created to assess surgeon demographics, practice and screening patterns, and attitudes toward surgical collaboration. We also evaluated obstacles to performing joint procedures and assessed whether attitudes could be influenced by new information.ResultsA total of 338 surveys were included in the analysis, including 158 urogynecologists and 226 gynecologic oncologists (GOs). Most surgeons (77.8%) will recommend concurrent procedures with another specialty, and 97.8% of urogynecologists and 95.7% of oncologists currently perform joint surgical procedures. Male surgeons, regardless of specialty, were more likely to recommend staged procedures (44% vs 31%, P < 0.001), as were GOs (28% vs 10.1%, P < 0.001). However, oncologists were more likely than urogynecologists to initiate referrals for surgical collaboration (33.3% vs 14.4%, P < 0.001).ConclusionsA total of 22.2% of urogynecologists and oncologists prefer staging surgical procedures. The most common barrier to a combined procedure was logistics. Urogynecologists were more concerned about the effects of cancer treatments on healing, the use of mesh implants, and financial reimbursements as compared with GOs. Treatment delay was a significantly greater concern for the oncologists.

show abstract

Concomitant Repair of Pelvic Floor Disorders in Women Undergoing Surgery for Gynecologic Malignancies

Abstract: Using a large national surgical database, only 2.4% of women undergoing gynecologic cancer surgery had a concomitant POPUI procedure. Our data suggest that postoperative complications may not increase when concomitant surgery for POPUI is done at the time of gynecologic cancer surgery.

Cited by 13 publications

References 13 publications

Perioperative Outcomes of Combined Gynecologic Oncology and Urogynecologic Surgeries

Perioperative Outcomes of Combined Gynecologic Oncology and Urogynecologic Surgeries

Functional Changes of the Genitourinary and Gastrointestinal Systems before and after the Treatment of Endometrial Cancer—A Systematic Review

Surgeon Attitudes Toward Concurrent Urogynecologic and Gynecologic Oncology Procedures: A Cross-sectional Survey

Contact Info

Product

Resources

About