Pelvic organ prolapse after 3 modes of hysterectomy: long-term follow-up

• Published in: American journal of obstetrics and gynecology 2021-05, Vol.224 (5), p.496.e1-496.e10
• Main Authors: Gabriel, Iwona, Kalousdian, Anthony, Brito, Luiz Gustavo, Abdalian, Talar, Vitonis, Allison F., Minassian, Vatche Arakel
• Format: Article
• Language: English
• Subjects: abdominal hysterectomy; laparoscopic hysterectomy; pelvic organ prolapse; robotic hysterectomy; vaginal hysterectomy
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2020.11.008

There are various indications and approaches for hysterectomy; yet, the difference in long-term risk of subsequent prolapse after surgery is not well studied. To assess the risk of prolapse after abdominal, vaginal, and laparoscopic or robotic hysterectomy for up to 17 years from surgery. A retrospective chart review study of women undergoing hysterectomy across all indications (benign and malignant) between 2001 and 2008 was conducted. An equivalent random sample of hysterectomy patients was selected each year. We compared demographic and other surgical characteristics data including age, race, parity, body mass index, indication and year of hysterectomy, blood loss, cervix removal, cuff suspension, and complications using chi-square, Kruskal-Wallis test, and Fisher’s exact across the 3 groups. Presence and treatment of subsequent prolapse (based on patient symptoms, pelvic exam, International Classification of Diseases, Ninth Revision diagnosis, and current procedural terminology pessary or surgical codes) were compared with Kaplan-Meier survival analysis and Cox proportional hazards regression. Of the 2158 patients, 1459, 375, and 324 underwent open, vaginal, and laparoscopic or robotic hysterectomy, respectively. The vaginal group (56) was older than the abdominal (52) or laparoscopic or robotic (49) groups, with a P value of