The overall complication rate was 3.5%, with the majority (84.3%) of complications being UTIs. Thirty-day postoperative outcomes, including cardiovascular, pulmonary, thrombotic, septic, renal, wound, and bleeding complications, did not differ between the two specialties. Reoperation and readmission rates were also similar.
The above rates were similar despite differing patient characteristics. Patients treated by urologists tended to be older with a greater incidence of comorbidity and higher American Society of Anesthesiologist scores (ASA ≥3, p=.05).
It is possible the complication rates are under-reported, noted Dr. Löppenberg, who worked on the study with Quoc-Dien Trinh, MD, and co-authors.
“The NSQIP database codes only for complications that occur within 30 days of the procedure. We cannot account for long-term adverse events such as chronic pain and erosion, among others,” said Dr. Löppenberg, who explained that these complications would not be registered in the NSQIP database.
Some 17.1% of the patients in the dataset underwent an additional procedure. Gynecologists performed twice as many additional procedures as urologists, 22.2% versus 10.5% (p<.0001), despite the higher comorbidity rates seen among patients being treated by urologists.
“We are not able to identify the underlying reason for this finding. The majority of these additional procedures were cystoscopies, and the majority were performed by gynecologists. It is possible that these findings simply reflect differences in surgical technique and approach,” Dr. Löppenberg said.