Hysterectomy Versus Uterine Preservation at the Time of Pelvic Reconstructive Surgery

Objective To evaluate national trends in apical prolapse surgery with and without uterine preservation using the National Surgical Quality Improvement Program (NSQIP) database. Methods Based on the International Classification of Diseases (ICD) and Current Procedural Terminology (CPT) codes, patients diagnosed with uterovaginal prolapse who underwent apical suspensions between 2013 and 2018 were identified, and procedures involving uterine preservation were differentiated from those with concomitant hysterectomy. Patient characteristics and postoperative complications were analyzed. Results A total of 16 427 patients met inclusion criteria, with 2235 (13.6%) undergoing uterine-preservation procedures and 14 192 (86.4%) undergoing hysterectomy. Between 2013 and 2018, the rates of uterine preservation ranged from 12.8% to 15.3%, with the last 2 years having significantly lower rates. Patients in the uterine-preservation group were older (62.8 vs. 60.5 y, P Conclusions Patients with more comorbidities were more likely to undergo uterine-preserving surgeries, which offered reduced operative time and no differences in postoperative complications.