Racial and ethnic differences in Reconstructive Surgery for
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According to research by the American Journal of Obstetrics & Gynecology, racial and ethnic differences are present in the type and route of surgical repair for the treatment of apical vaginal prolapse.

The objective of this study was to evaluate differences in surgical approach for apical vaginal prolapse and postoperative complications by race and ethnicity.

This is a retrospective cohort study of women undergoing surgical repair for apical vaginal prolapse. Patients were eligible for inclusion if they underwent either a vaginal colpopexy or abdominal sacrocolpopexy (ASC). Abdominal sacrocolpopexy cases were further divided into those performed by laparotomy and those performed by laparoscopy. Multivariable logistic regression models were used to determine if race and ethnicity are associated with the type of colpopexy (vaginal vs. abdominal) or the surgical route of abdominal sacrocolpopexy. A total of 22,861 eligible surgical cases were identified, of which 12,337 were vaginal colpopexy and 10,524 were an abdominal sacrocolpopexy.

--Among patients who had an abdominal sacrocolpopexy, 2,262 were performed via laparotomy and 8,262 via laparoscopy.

--In multivariable analysis, Asian and Native Hawaiian or Pacific Islander women were less likely to undergo abdominal sacrocolpopexy compared with White women.

--Among women who underwent an abdominal sacrocolpopexy, Latina women and Native Hawaiian or Pacific Islander women were less likely to undergo a laparoscopic approach compared with White women.

--Complication rates also differed by race and ethnicity. Following a colpopexy, African American women were more likely to need a blood transfusion and have a deep vein thrombosis/pulmonary embolus, but less likely to present with postoperative urinary tract infections compared with White women in multivariable regression models.

--Using the Clavien-Dindo classification system, Latina women had a higher odds of developing Grade II complications compared with White women in multivariable models.

In particular, Latina and Pacific Islander women were less likely to undergo a laparoscopic approach to abdominal sacrocolpopexy compared with White women. While complications were uncommon, there were several complications including blood transfusions that were higher among African American and Latina women.

Source: https://doi.org/10.1016/j.ajog.2021.05.002
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