# HbA1c as a Predictor of Complications in Anterior and Posterior Colporrhaphy

## TL;DR

This study finds that higher HbA1c levels are linked to increased surgical complications after colporrhaphy procedures.

## Contribution

The study is the first to show that HbA1c is a significant predictor of complications in anterior and posterior colporrhaphy.

## Key findings

- Patients with HbA1c ≥6.5 had three times higher odds of complications compared to those with HbA1c ≤6.4.
- The most common complication was urinary tract infection.
- Higher HbA1c was associated with increased composite complication rates (21.7% vs. 10.3%).

## Abstract

Importance: Colporrhaphy is a surgical option for anterior or posterior compartment vaginal prolapse. Colporrhaphy has a high complication rate. Previous literature proved that individuals diagnosed with diabetes had higher rates of complications in other urological surgeries, especially in prosthesis or mesh insertion.

Objective: This study aims to determine if HbA1c is associated with anterior or posterior colporrhaphy complications.

Study design: The 2021 National Surgical Quality Surgical Improvement database was used for a retrospective review study of patients who had anterior or posterior colporrhaphy. The cohort was subdivided into those with HbA1c ≤6.4 and those with ≥6.5. In a 30-day composite, major and minor complications were analyzed. A multivariate logistic regression was then performed to predict complications.

Results: A total of 182 patients were included, with 46 (25.3%) in the ≥6.5 cohort and 136 (74.7%) in the ≤6.4 cohort. The ≥6.5 group was older (67.9 years vs. 64.1 years), whereas there was no noted difference in race, hypertension, or previous abdominal operations. The composite complication was higher in the ≥6.5 group at 21.7% (n = 10) compared to 10.3% (n = 14) in the ≤6.4 group. The most common complication was urinary tract infection (8.2%, n = 15). On adjusted analysis, the ≥6.5 group had higher odds of complication (OR 3.16, p = 0.05).

Conclusions: Diabetes should be considered a comorbidity in patients undergoing anterior or posterior colporrhaphy. Our study shows that there are three times the odds of complications in patients with higher HbA1c. Strict glycemic control should be implemented to decrease the risk.