Inflammatory Bowel Disease and Complications After Pelvic Organ Prolapse Repair.

IMPORTANCE

Inflammatory bowel disease (IBD) affects 1.5% of women and results in relapsing inflammation affecting the gastrointestinal (GI) tract, which can lead to intra-abdominal adhesive disease, malnutrition, and immunosuppression, factors associated with adverse surgical outcomes. Whether patients with IBD undergoing pelvic organ prolapse (POP) surgery are at an increased risk of postoperative complications is unknown.

OBJECTIVE

The objective of this study was to compare postoperative complication rates up to 12 months after POP surgery between patients with and without IBD.

STUDY

DESIGN

This was a retrospective cohort study of patients who underwent POP surgery between 2000 and 2020 using the Premier Healthcare Database. Postoperative complications were compared between patients with and without IBD, with a subanalysis of surgical approach and IBD subtype.

RESULTS

Among 173,489 POP repairs, 6,349 patients (3.7%) had IBD. Patients with IBD had higher 3-month GI complication rates than those without IBD (1.4% vs 0.99%, P =0.029), which persisted for 12 months (2.9% vs 1.7%, P <0.001). Patients with IBD had a higher risk of ileus (OR: 1.8; 95% CI: 1.2-2.6), small bowel obstruction (OR: 1.8; 95% CI: 1.2-2.1), and wound infection (OR: 2.1; 95% CI: 1.1-4.3) at 12 months. IBD subtype was not associated with increased 3-month GI complications ( P >0.05). GI complications were higher among patients with IBD undergoing intraperitoneal repair at 3 months (2.1% vs 1.0%, P =0.003) and 12 months (3.4% vs 1.7%, P ≤0.001). Multivariable logistic regression revealed IBD was independently associated with increased GI complications (OR: 2.06; 95% CI: 1.67-2.53).

CONCLUSION

Patients with IBD have increased GI complication risks after prolapse surgery compared with patients without IBD.