Female pelvic medicine & reconstructive surgery · 2021
Surgical Correction of Pelvic Organ Prolapse Has No Effect on Renal Function.
СтатьяНазвание и аннотация: Перевод в очереди
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Derisavifard Samir, Chang Olivia H, Propst Katie, Goldman Howard B
Аннотация
OBJECTIVE: The aims of the study were to determine whether symptomatic pelvic organ prolapse (POP) is a cause of subclinical renal impairment by characterizing baseline renal function in women undergoing surgical correction for POP and to assess the effect of surgical POP repair on estimated glomerular filtration rate (eGFR) postoperatively.
METHODS: A prospective cohort study was designed to evaluate women undergoing surgical repair for at least stage II anterior or apical POP at a single institution. Data collected included preoperative serum creatinine values, patient demographics, and clinical risk factors for renal impairment. Postoperative serum creatinine values were obtained at routine 4- to 6-week follow-up. At that time, patients were evaluated for objective and subjective surgical success and surveyed on postoperative nonsteroidal anti-inflammatory drug use. Preoperative eGFRs were calculated and compared with postoperative values. Appropriate statistical tests were performed.
RESULTS: A total of 25 participants were recruited between August 2019 and March 2020. The median age was 70 years (interquartile range, 62-73 years). One participant (4%) reported a history of stage III chronic kidney disease preoperatively. At a median follow-up of 40 days (interquartile range, 34-49 days), no prolapse was recorded past the level of the hymen. There was no difference between preoperative and postoperative eGFR (median preoperative, 81 vs 76 mL/min per 1.73 m2, P = 0.3). Higher POP stage was not associated with significant changes in postoperative eGFR (P = 0.09).
CONCLUSIONS: Surgical POP repair is not associated with any change in eGFR. It is unlikely that untreated POP causes subclinical renal impairment in the vast majority of women.
METHODS: A prospective cohort study was designed to evaluate women undergoing surgical repair for at least stage II anterior or apical POP at a single institution. Data collected included preoperative serum creatinine values, patient demographics, and clinical risk factors for renal impairment. Postoperative serum creatinine values were obtained at routine 4- to 6-week follow-up. At that time, patients were evaluated for objective and subjective surgical success and surveyed on postoperative nonsteroidal anti-inflammatory drug use. Preoperative eGFRs were calculated and compared with postoperative values. Appropriate statistical tests were performed.
RESULTS: A total of 25 participants were recruited between August 2019 and March 2020. The median age was 70 years (interquartile range, 62-73 years). One participant (4%) reported a history of stage III chronic kidney disease preoperatively. At a median follow-up of 40 days (interquartile range, 34-49 days), no prolapse was recorded past the level of the hymen. There was no difference between preoperative and postoperative eGFR (median preoperative, 81 vs 76 mL/min per 1.73 m2, P = 0.3). Higher POP stage was not associated with significant changes in postoperative eGFR (P = 0.09).
CONCLUSIONS: Surgical POP repair is not associated with any change in eGFR. It is unlikely that untreated POP causes subclinical renal impairment in the vast majority of women.