Reoperation 10 years after surgically managed pelvic organ prolapse and urinary incontinence

Objective This study measured the 10-year risk of reoperation for surgically treated pelvic organ prolapse and urinary incontinence (POPUI) in a community population. Study Design We conducted a prospective cohort analysis of 374 women who were > 20 years old and who underwent surgery for POPUI i...

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Bibliographic Details
Published in:American journal of obstetrics and gynecology 2008-05, Vol.198 (5), p.555.e1-555.e5
Main Authors: Denman, Mary Anna, MD, Gregory, W. Thomas, MD, Boyles, Sarah H., MD, MPH, Smith, Virginia, MD, Edwards, S. Renee, MD, Clark, Amanda L., MD
Format: Article
Language:English
Subjects:
Adult
Aged
Biological and medical sciences
Female
Gynecologic Surgical Procedures - methods
Gynecology. Andrology. Obstetrics
Humans
Medical sciences
Middle Aged
Nephrology. Urinary tract diseases
Obstetrics and Gynecology
pelvic organ prolapse
Recurrence
Reoperation
Risk Factors
surgery
urinary incontinence
Urinary Incontinence - epidemiology
Urinary Incontinence - surgery
Urinary system involvement in other diseases. Miscellaneous
Urinary tract. Prostate gland
Uterine Prolapse - epidemiology
Uterine Prolapse - surgery
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Summary:Objective This study measured the 10-year risk of reoperation for surgically treated pelvic organ prolapse and urinary incontinence (POPUI) in a community population. Study Design We conducted a prospective cohort analysis of 374 women who were > 20 years old and who underwent surgery for POPUI in 1995. Results The 10-year reoperation rate was 17% by Kaplan Meier analysis. Previous POPUI surgery at the time of index surgery conferred a hazard ratio of 1.9 (95% CI, 1.1-3.2; P = .018). The abdominal approach was protective against reoperation compared with the vaginal approach (hazard ratio, 0.37; 95% CI, 0.17-0.83; P = .02) With the use of Cox regression, no association was observed for age, vaginal parity, previous hysterectomy, body mass index, prolapse severity, ethnicity, chronic lung disease, smoking, estrogen status, surgical indication, or anatomic compartment. Conclusion A reoperation rate of 17% is unacceptably high and likely represents an underestimate of the true rate. Most of the factors that influence reoperation have not yet been identified.
ISSN:0002-9378
1097-6868
DOI:10.1016/j.ajog.2008.01.051