Complication Rates are Low for Women Aged 70 and Older Undergoing Sacrocolpopexy.

Abstract

Introduction and hypothesis: Aging may place patients at greater risk for adverse perioperative outcomes. We hypothesized that women undergoing minimally invasive (MIS) sacrocolpopexy aged ≥ 70 years are more likely to experience adverse events (AE) within 8 weeks of surgery.

Methods: We performed a secondary analysis of a retrospective study on perioperative adverse events in women ≥ 61 years old undergoing prolapse surgery at a single academic center from January 2016 to May 2023. Only women undergoing MIS sacrocolpopexy were included. The primary outcome was a composite 8-week AE outcome. Secondary outcomes included prolapse recurrence and mesh complication. Variables were compared between the groups using t-test (or Mann-Whitney U) and chi-square (or Fisher's exact) analyses. Multivariable logistic regression was performed, controlling for variables with p < 0.05 on univariate analysis.

Results: Of the 709 women who underwent MIS sacrocolpopexy, 29.9% (n = 212) were aged ≥ 70 years. Age ≥ 70 was not significantly associated with 8-week perioperative AEs, nor was it associated with prolapse recurrence or mesh complication. The composite AE outcome was not associated with age ≥ 70 on multivariable analysis, controlling for CCI score, robotic approach, and concomitant hysterectomy (adjusted odds ratio (aOR) 0.64, 95% confidence interval (CI) [0.38-1.10]). Women aged ≥ 70 years had a 73% lesser adjusted odds of surgical site infections on multivariable analysis (95% CI [0.08-0.93]).

Conclusions: Age ≥ 70 years is not associated with perioperative AEs, prolapse recurrence, or mesh complication. These findings highlight the safety profile of this surgical approach in older women, an important consideration for urogynecologic surgeons caring for an aging population.