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Objective To assess the incidence of serious complications and reoperations for recurrence after surgery for pelvic organ prolapse (POP) and compare the three most common types of repair. Design Prospective cohort study using a registry. Setting Nineteen French surgical centres. Population A total of 2309 women participated between 2017 and 2019. Methods A multivariate analysis including an inverse probability of treatment weighting approach was used to obtain three comparable groups. Main outcome measures Serious complications and subsequent reoperations for POP recurrence. Results The median follow-up time was 17.6 months. Surgeries were native tissue vaginal repairs (n = 504), transvaginal mesh placements (n = 692) and laparoscopic sacropexies with mesh (n = 1113). Serious complications occurred among 52 women (2.3%), and reoperation for POP recurrence was required for 32 women (1.4%). At 1 year the cumulative weighted incidence of serious complications was 1.8% for native tissue vaginal repair, 3.9% for transvaginal mesh and 2.2% for sacropexy, and the rates for reoperation for recurrence of POP were 1.5, 0.7 and 1.1%, respectively. Compared with native tissue vaginal repair, the risk of serious complications was higher in the transvaginal mesh group (weighted hazard ratio, wHR 3.84, 95% CI 2.43-6.08) and the sacropexy group (wHR 2.48, 95% CI 1.45-4.23), whereas the risk of reoperation for prolapse recurrence was lower in both the transvaginal mesh (wHR 0.22, 95% CI 0.13-0.39) and sacropexy (wHR 0.29, 95% CI 0.18-0.47) groups. Conclusions Our results suggest that native tissue vaginal repairs have the lowest risk of serious complications but the highest risk of reoperation for recurrence. These results are useful for informing women and for shared decision making. Tweetable abstract Laparoscopic sacropexy had fewer serious complications than transvaginal mesh and fewer reoperations for recurrence than vaginal repair.

170 Background: JJ stent is designed to be placed for short periods. In rare cases, long-term JJ can be considered particularly in malignant ureteric obstruction. The objective of this study was to assess tolerance and complications in patients with indwelling JJ. Methods: Data from consecutive patients who had a JJ stent placed for more than 6 months between 1992 and 2013 were analyzed. Patients were all followed in a single center where JJ stents were changed every 6 months or earlier in case of complications. Results: The study included 36 patients (22 female and 14 male). Mean age was 69.4 yrs. Median ASA 3 (IQ = 1). Mean creatinine before the 1st JJ 204 micromol/L (SD 232). Most frequent causes of obstruction were colorectal (30%), gynecological (25%) and prostate cancer (14%). In 7 cases, a bilateral JJ stent was placed. Median FU was 26.4 months. Median number of JJ changed per patient was 5.5 (IQ 6.0). Median duration for each JJ was 6 months (IQ 2.1). There was one case of broken stent and 5 cases of stent encrustation, all being managed endoscopically in a single procedure.Grade III-IV complications following theClavien-Dindo classification are reported in the table. All 17 deaths (47.2%) were related to cancer progression. Conclusions: Long-term complications related to indwelling JJ stents are not uncommon. However, we found that when changing the stent systematically every 6 months (or earlier in case of complications), and when taking into account the patient's situation (status/disease) that led to the indwelling JJ indication, tolerance and rate of complications were acceptable. [Table: see text]

360 Background: The aim of this retrospective study was to evaluate the prognostic value of NLR in NMIBC as it was recently suggested in the literature. Methods: Patients included in the study were diagnosed between 1992 and 2013 with a T1 stage bladder cancer either primarily or following progression. NLR was calculated using the pre-operative (TURB or cystectomy) work-up. Results were expressed as median and interquartile range (IQ) unless indicated otherwise. Results: Seventy-eight patients were analyzed (12 females and 67 males). Mean age: 68.3 years. At diagnosis (1st TURB): median grade according to the WHO 1973 classification: 3 (IQ = 1), median NLR: 3.1 (IQ = 2.4 and range 1.0- 25.7). There was no significant difference between NLR when comparing stage, grade and gender subgroups. During FU (median 6.2 years): median number of TURB: 3.3. Observed NLR was higher in the highest risk groups, however the difference was significant only for grade progression and when comparing pT0 stage vs pTa or higher at the last biopsy/TURB (see table). NLR variation for each patient (NLR at diagnosis – NLR at the last TURB) was not associated with bladder tumor evolution. Conclusions: We found that NLR was higher in NMIBC with a high risk of progression. These data warrant a further evaluation of this potential, readily available prognostic marker in NMIBC. [Table: see text]