Postoperative appointments: which ones count?
Abstract
Introduction and hypothesis Although postoperative complications in women undergoing reconstructive pelvic surgery (RPS) have been characterized, little is known regarding the timeline of these occurrences. We aimed to determine the timeframe after RPS during which the majority of complications occur, to assist with planning intervals between postoperative visits.Methods Women undergoing RPS were identified through billing information. Demographic, surgical, and complications data were extracted from electronic medical records. The Pelvic Floor Complication scale is a surgical scale tailored to women undergoing RPS. It contains three subscales: intraoperative, immediately postoperative, and delayed complications. We applied this scale to each postoperative visit (at 2, 6, and 13 weeks).Results 396 women underwent RPS and 125 patients had 179 complications, most of which (66 %) were identified by the 2-week visit. Complications at the 2-week visit consisted of urinary tract infection (UTI; 46 %), wound infection (10.0 %), and urinary retention (9.4 %). The majority of serious complications (venous thromboembolism [VTE], ileus, small bowel obstruction [SBO], readmission, and reoperation [1 incarcerated hernia and 1 sling release]) were diagnosed by 2 weeks. One patient was readmitted for ileus at between 2 and 6 weeks. At between 6 and 13 weeks, 1 patient was readmitted with SBO; 1 VTE was diagnosed; and 1 required reoperation for a prolapsed fallopian tube. In contrast, two thirds of the complications seen at the 13-week visit were due to granulation tissue, suture erosion or mesh erosion.Conclusions The majority of non-mesh-related complications occur within the first 2 weeks after RPS, whereas mesh and suture complications are more likely to be identified at the 13-week visit.
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Most serious complications occur before the two-week postoperative appointment, while other foreign body complications such as mesh erosion may take longer.
“While most serious complications occur before a two week postoperative appointment, other foreign body complications, such as mesh erosion, may take longer [23].”
From Outpatient visits versus telephone interviews for postoperative care: a randomized controlled trial (2019) · cites this paper as [23]
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Outpatient visits versus telephone interviews for postoperative care: a randomized controlled trial
Thompson, J. C., Cichowski, S. B., Rogers, R. G., Qeadan, F., Zambrano, J., Wenzl, C., Jeppson, P. C., Dunivan, G. C., & Komesu, Y. M. (2019) · International Urogynecology Journal · doi:10.1007/s00192-019-03895-z · Cited by 82 · see citing works
- Authors
- Mueller, M. G., Elborno, D., Davé, B. A., Leader-Cramer, A., Lewicky-Gaupp, C., & Kenton, K.
- Affiliations
- Northwestern University (US)
- Loyola University Chicago (US)
- Corresponding author
- Mueller, Margaret G.
- Venue
- International Urogynecology Journal
- Published
- 2016-06-16
- Volume
- 27
- Issue
- 12
- Pages
- 1873-1877
- ISSN
- 0937-3462 (ISSN-L)
- 1433-3023
- OpenAlex
- W2442945039
- Cited by
- 10
- References
- 22
- Citations by year
- 2026: 1 · 2023: 2 · 2021: 1 · 2020: 1 · 2019: 2 · 2018: 2
- FWCI
- 1.42
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Urogynecology Journal (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
- Health Sciences › Medicine › Surgery › Hernia repair and management
- Health Sciences › Medicine › Obstetrics and Gynecology › Uterine Myomas and Treatments
- Keywords
- pelvic reconstruction, postoperative complications, postoperative follow-up visits, urinary tract infection, wound infection, urinary retention, venous thromboembolism, mesh erosion, granulation tissue, suture erosion, pelvic organ prolapse
- MeSH terms
- Adult, Aged, Appointments and Schedules, Chicago, Female, Humans, Middle Aged, Postoperative Complications, Gynecologic Surgical Procedures, Time Factors, Urinary Incontinence, Stress, Pelvic Organ Prolapse
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