Recent changes in female pelvic reconstructive surgery trends in Japan; using a Japanese national database
MS Yuki Irie (1), Dr Daisuke Obinata (1), Mr Shugo Suzuki (1), Mr Sho Hashimoto (1), Mr Ken Nakahara (1), Mr Daigo Funakoshi (1), Mr Fuminori Sakurai (1), Dr Yutaro Hori (1), Dr Tsuyoshi Yoshizawa (1), Dr Junichi Mochida (1), Dr Kenya Yamaguchi (1), Prof Satoru Takahashi (1)
(1) Department of Urology, Nihon University School Of Medicine, Tokyo, Japan
The United States FDA issued statements about the safety of transvaginal mesh (TVM) and finally reclassified TVM as a high-risk device in pelvic organ prolapse repair. Laparoscopic sacrocolpopexy (LSC) has been approved in the Japanese public insurance in 2014. In this study, we examined the trends in TVM and LSC in Japan, and outcomes of these surgeries using a Japanese national database.
We used the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB). The number of TVM and LSC were reviewed from 2014 to 2016 at this database. In addition, Diagnosis Procedure Combination (DPC) database, a Japanese national inpatient database was reviewed from 2014 to 2015 and conducted the present study to compare the proportion of perioperative adverse events and duration of anaesthesia between TVM and LSC cases.
The number of TVM surgery slightly decreased during this period (Table 1). The DPC database during 2014-2015 period indicated that TVM group was significantly higher age than the LSC group. In terms of adverse events, the TVM group had a higher rate of occurrence than the LSC group. However, the median duration of anaesthesia in TVM group was shorter than in LSC group.
Although the number of TVM cases was significantly decreased, over 4000 cases were performed every year. These findings may provide a novel evidence for appropriate choice of the surgical options for POP.