• Anke R Mothes, Henning K Mothes, Marc P Radosa, and Ingo B Runnebaum.
• Department of Gynecology and Obstetrics, Jena University Hospital, Friedrich-Schiller-University Jena, Bachstreet 18, 07743, Jena, Germany.
• Arch. Gynecol. Obstet. 2015 Jun 1;291(6):1297-301.

PurposeTo systematically review surgical complications of vaginal native tissue prolapse repair using Clavien-Dindo classification and to show whether concomitant surgery leads to increased complication rates.MethodsRetrospective analysis of complications in 438 consecutive vaginal native tissue prolapse repairs and subgroup analysis was performed for concomitant hysterectomy or sacrospinous fixation for level I defects using Fisher's exact tests.ResultsAnterior and posterior colporrhaphia was performed in all 438 patients and sacrospinous fixation (SSF) for level I defects in 269 patients. Prolapse repair was combined with hysterectomy in 255 cases. One intra-operative bladder lesion (0.23%) and one rectal lesion (0.23%) occurred. Postoperative urinary tract infection requiring antibiotics was noted in 34 cases (7.8%). Post-void residual volume was medically treated in 24 cases (5.5%). Four patients (0.9%) underwent postoperative suprapubic catheter insertion. Asymptomatic gluteal hematomas were noted in 11 cases (2.5%). Four patients (0.9%) underwent re-operations for postoperative hemorrhage. Mean hospital stay was 5.6 days. Minor complications were classified as CD grade I in 2.5%, as CD grade II in 13.2%, complications requiring surgical intervention as grade IIIa in 0.9% and as grade IIIb in 0.9% of patients. No CD grade IV or V complications occurred. Apart from gluteal hematomas classified as CD grade I occurring in the SSF group (p = 0.019), no other differences of complication rates were found in the hysterectomy subgroup or in the SSF subgroup.ConclusionSurgery was associated with low rate of CD grade III complications. Re-operation rate was 0.9%. The authors suggest introduction of CD classification for comparability of prolapse surgery.

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