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This retrospective analysis utilized the NSQIP database to evaluate whether adding hysteroscopy to laparoscopic myomectomy procedures increased the risk of surgical site infections or urinary tract infections. The study compared outcomes in patients undergoing myomectomy alone versus those receiving concomitant hysteroscopy, adjusting for various demographic and clinical variables including age, BMI, and operative time. Results indicated that the addition of hysteroscopy was not associated with a statistically significant increase in any type of surgical site infection or postoperative urinary tract infection within 30 days. Relevance to endometriosis: The paper explicitly controlled for the presence of endometriosis as a baseline comorbidity in its multivariate regression model, though the primary focus remains on myomectomy safety rather than endometriosis pathology or treatment.
Abstract
OBJECTIVE: We aimed to determine whether hysteroscopy at the time of laparoscopic myomectomy significantly increased the risk of surgical site infection (SSI).
DESIGN: A cohort from the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) retrospective database. The primary outcome was any surgical site infection within 30 days postoperatively. Further analysis of superficial, deep, and organ space infections was individually performed. Secondary outcome was postoperative urinary tract infection (UTI). Multivariate logistic regression was used to control for other risk factors for surgical site infection. The study was IRB exempt.
SETTING: The ACS NSQIP database is a national validated database from academic and community hospitals.
PARTICIPANTS: Individuals who had a laparoscopic myomectomy in the years 2015 to 2023.
INTERVENTIONS: Laparoscopic myomectomy alone versus laparoscopic myomectomy with concomitant hysteroscopy.
MEASUREMENTS AND MAIN RESULTS: The addition of hysteroscopy was not associated with a significant difference in the rates of any SSI (aOR 0.82; 95% CI 0.56-1.17, p = .3), superficial SSI (aOR 0.76, 95% CI 0.48-1.14, p = .2), deep SSI (aOR 1.59, 95 % CI 0.08-10.4, p = .7), organ space SSI (aOR 1.23, 95% CI 0.52-2.20, p = .7), or postoperative UTI (aOR 0.69, 95% CI 0.34-1.24, p = .2) controlling for age, body mass index, American Society of Anesthesiologists Physical Status class, tobacco use, diabetes, blood transfusion, operative time, inpatient versus outpatient procedure, race, and presence of endometriosis.
CONCLUSION: After controlling for baseline comorbidities and surgical complexity, concomitant hysteroscopy with laparoscopic myomectomy does not significantly increase 30-day rates of SSIs or postoperative UTIs.
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Infectious Morbidity Risk of Laparoscopic Myomectomy Concomitant Hysteroscopy: A National Surgical Quality Improvement Program (NSQIP) Analysis
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OBJECTIVE: We aimed to determine whether hysteroscopy at the time of laparoscopic myomectomy significantly increased the risk of surgical site infection (SSI). DESIGN: A cohort from the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) retrospective database. The primary outcome was any surgical site infection within 30 days post-operatively. Further analysis of superficial, deep, and organ space infections was individually performed. Secondary outcome was post-operative urinary tract infection (UTI). Multivariate logistic regression was used to control for other risk factors for surgical site infection. The study was IRB exempt. SETTING: The ACS NSQIP database is a national validated database from academic and community hospitals. PARTICIPANTS: Individuals who had a laparoscopic myomectomy in the years 2015-2023. INTERVENTIONS: Laparoscopic myomectomy alone versus laparoscopic myomectomy with concomitant hysteroscopy. MEASUREMENTS AND MAIN RESULTS: The addition of hysteroscopy was not associated with a significant difference in the rates of any SSI (aOR 0.82; 95% CI 0.56-1.17, P=0.3), superficial SSI (aOR 0.76, 95% CI 0.48-1.14, P=0.2), deep SSI (aOR 1.59, 95 % CI 0.08-10.4, P=0.7), organ space SSI (aOR 1.23, 95% CI 0.52-2.20, P=0.7), or postoperative UTI (aOR 0.69, 95% CI 0.34-1.24, P=0.2) controlling for age, body mass index, American Society of Anesthesiologists Physical Status class, tobacco use, diabetes, blood transfusion, operative time, inpatient versus outpatient procedure, race, and presence of endometriosis. CONCLUSION: After controlling for baseline comorbidities and surgical complexity, concomitant hysteroscopy with laparoscopic myomectomy does not significantly increase 30-day rates of SSIs or postoperative UTIs.
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