Vaginal Complications after Bladder Cystectomy: Results from a Medicare Sample. Vaginal Complications after Cystectomy: Results from a Medicare Sample.

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Citation: Journal of Urology. 207(4):789-796, 2022 Apr.PMID: 34854750Institution: MedStar Washington Hospital CenterDepartment: Obstetrics and Gynecology/UrogynecologyForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Cystectomy/ae [Adverse Effects] | *Urinary Bladder Neoplasms/su [Surgery] | *Vagina/in [Injuries] | *Vaginal Diseases/et [Etiology] | Aged | Aged, 80 and over | Dyspareunia/et [Etiology] | Female | Humans | Medicare | Postoperative Complications | Retrospective Studies | Surgical Wound Dehiscence/et [Etiology] | United States | Uterine Prolapse/et [Etiology] | Vaginal Fistula/et [Etiology]Year: 2022Local holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006ISSN:
  • 0022-5347
Name of journal: The Journal of urologyAbstract: CONCLUSIONS: Among women who undergo cystectomy, vaginal complications occur at rates higher than expected with over 20% of women experiencing a complication and over a quarter of those diagnosed undergoing intervention.MATERIALS AND METHODS: Women 65 or older undergoing cystectomy for any indication were identified by procedural codes in the Medicare Limited Data Set 5% sample from January 1st 2011 to December 31st 2017. Patients experiencing a vaginal complication after cystectomy were compared to those who did not. Demographic and biological factors that could increase likelihood of complications were identified and time to development of complications determined. Cumulative incidence was calculated using Kaplan-Meir estimates. Multivariable cause-specific Cox proportional hazards model assessed risk factors for vaginal complications.PURPOSE: Cystectomy with a vaginal sparing approach may be associated with unique complications specific to the female population. The objective of this study was to estimate the incidence of vaginal complications (defined to include vaginal prolapse, vaginal fistula, dyspareunia, and vaginal cuff dehiscence/evisceration) after cystectomy and to determine risk factors for these complications.RESULTS: 481 women undergoing cystectomy were identified during the study period, 37.2% were less than 70 years old. The majority 378 (79%) had bladder cancer and 401 (83.4%) underwent an incontinent conduit or catheterizable channel diversion. Within two years of cystectomy, 93 patients (19.5%) had one or more complications on record. Vaginal cuff dehiscence had the highest cumulative incidence, occurring in 49 patients (10.2%). Over the entire study period (2011-2017), 102 women (21.2%) were diagnosed with a vaginal complication, and 27 (5.6%) received an intervention.All authors: Handa V, Osazuwa-Peters O, Richter LA, Routh JOriginally published: Journal of Urology. :101097JU0000000000002336, 2021 Dec 02Fiscal year: FY2022Digital Object Identifier: Date added to catalog: 2022-01-25
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 34854750 Available 34854750

Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006

CONCLUSIONS: Among women who undergo cystectomy, vaginal complications occur at rates higher than expected with over 20% of women experiencing a complication and over a quarter of those diagnosed undergoing intervention.

MATERIALS AND METHODS: Women 65 or older undergoing cystectomy for any indication were identified by procedural codes in the Medicare Limited Data Set 5% sample from January 1st 2011 to December 31st 2017. Patients experiencing a vaginal complication after cystectomy were compared to those who did not. Demographic and biological factors that could increase likelihood of complications were identified and time to development of complications determined. Cumulative incidence was calculated using Kaplan-Meir estimates. Multivariable cause-specific Cox proportional hazards model assessed risk factors for vaginal complications.

PURPOSE: Cystectomy with a vaginal sparing approach may be associated with unique complications specific to the female population. The objective of this study was to estimate the incidence of vaginal complications (defined to include vaginal prolapse, vaginal fistula, dyspareunia, and vaginal cuff dehiscence/evisceration) after cystectomy and to determine risk factors for these complications.

RESULTS: 481 women undergoing cystectomy were identified during the study period, 37.2% were less than 70 years old. The majority 378 (79%) had bladder cancer and 401 (83.4%) underwent an incontinent conduit or catheterizable channel diversion. Within two years of cystectomy, 93 patients (19.5%) had one or more complications on record. Vaginal cuff dehiscence had the highest cumulative incidence, occurring in 49 patients (10.2%). Over the entire study period (2011-2017), 102 women (21.2%) were diagnosed with a vaginal complication, and 27 (5.6%) received an intervention.

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