Design: Retrospective cohort analysis

Setting: Data was procured from a U.S. National Database between January 2000 and March 2020

Patients or Participants: Patients who underwent WLS prior to surgery for POP, identified using Current Procedural Terminology codes

Interventions: Comparisons were made between patients with and without a history of WLS

Measurements and Main Results: Of 22,363 surgeries performed for POP, 542 (2.43%) previously underwent WLS with a median interval time of 30 months (IQR 15-51). The WLS group was significantly younger, had a lower Charlson comorbidity score, and had higher rates of class II or III obesity (p <0.001), and were less likely to undergo obliterative procedures (0.74% vs 2.9%, p=0.0038). Rates of hysterectomy, sacrocolpopexy, and midurethral mesh sling did not differ between groups. The WLS group had higher rates of anemia (17% vs 9.4%, p <0.001), dumping syndrome (1.3% vs 0.049%, p<0.001), and malabsorption (12% vs 0.44%, p<0.001). The WLS group had higher rates of mesh erosion at 3 months (3% vs 1.5%, p=0.0079) and 12 months postoperatively (3.1% vs 1.8%, p=0.04) and had higher hematoma incidence (1.7% vs 0.68%, p=0.014). Time interval between surgeries did not impact rates of mesh erosion and hematoma. There was no significant difference in rates of surgical site infection between patients with and without prior WLS.

Conclusion: Prior weight loss surgery was associated with increased rates of mesh erosion and hematoma after surgery for POP.