Preoperative evaluation of deep venous thrombosis in patients with pelvic organ prolapse

Abstract

Aim: The incidence of preoperative deep venous thrombosis (DVT) was examined in patients with pelvic organ prolapse (POP).

Material and methods: Preoperative screening for DVT was performed on the basis of D-dimer levels; if D-dimer levels were beyond the cut-off limit (0.5 μg/mL), ultrasound examination of the lower extremities was performed. A total of 75 consecutive patients who were scheduled for POP operation in our department were examined retrospectively.

Results: D-dimer levels were elevated in 24 patients (31.6%). Further, DVT was detected in 10 of the 75 patients, resulting in an incidence rate of 13.3% in the present study. D-dimer levels were significantly higher in the patients with DVT (1.25 ± 0.52 μg/mL vs 0.41 ± 0.26 μg/mL). There was no significant difference in age, and although body mass index and the number of diabetes mellitus cases were relatively higher in the patients with DVT than in those without DVT, there were no statistically significant differences. According to a receiver-operator curve, the suggested cut-off D-dimer value was 0.71 μg/mL (sensitivity and specificity was 0.9 and 0.877, respectively).

Conclusions: Although this was a preliminary study, to the best of our knowledge, this is the first report describing the incidence of preoperative DVT in patients with POP. Our study indicates that the incidence of DVT in patients with POP might have been underestimated thus far. Therefore, every surgeon should evaluate patients for DVT prior to any surgical procedure for POP, particularly in those patients with obesity or diabetes mellitus.

Keywords: D-dimer; age; body mass index; deep venous thrombosis; diabetes mellitus; pelvic organ prolapse.