Pelvic organ prolapse after hysterectomy: A 10‐year national follow‐up study

Introduction Hysterectomy may have an effect on the pelvic floor. Here, we evaluated the rates and risks for pelvic organ prolapse (POP) surgeries and visits among women with a history of hysterectomy for benign indication excluding POP. Material and methods In this retrospective cohort study 3582 w...

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Published in:Acta obstetricia et gynecologica Scandinavica 2023-05, Vol.102 (5), p.556-566
Main Authors: Kuittinen, Tea, Tulokas, Sari, Rahkola‐Soisalo, Päivi, Brummer, Tea, Jalkanen, Jyrki, Tomas, Eija, Mäkinen, Juha, Sjöberg, Jari, Härkki, Päivi, Mentula, Maarit
Format: Article
Language:English
Subjects:
different approaches
Female
Follow-Up Studies
Humans
Hysterectomy
Hysterectomy - adverse effects
Hysterectomy, Vaginal
Laparoscopy
Male
Original
Original s
Pelvic organ prolapse
Pelvic Organ Prolapse - etiology
Pelvic Organ Prolapse - surgery
POP operation
POP visit
Retrospective Studies
Vagina
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Summary:Introduction Hysterectomy may have an effect on the pelvic floor. Here, we evaluated the rates and risks for pelvic organ prolapse (POP) surgeries and visits among women with a history of hysterectomy for benign indication excluding POP. Material and methods In this retrospective cohort study 3582 women who underwent hysterectomy in 2006 were followed until the end of 2016. The cohort was linked to the Finnish Care Register to catch any prolapse‐related diagnoses and operation codes following the hysterectomy. Different hysterectomy approaches were compared according to the risk for a prolapse, including abdominal, laparoscopic, laparoscopic‐assisted vaginal and vaginal. The main outcomes were POP surgery and outpatient visit for POP, and Cox regression was used to identify risk factors (hazard ratios [HR]). Results During the follow‐up, 58 women (1.6%) underwent a POP operation, of which a posterior repair was the most common (n = 39, 1.1%). Outpatient visits for POP symptoms occurred in 92 (2.6%) women of which posterior wall prolapses (n = 58, 1.6%) were the most common. History of laparoscopic‐assisted vaginal hysterectomy were associated with risk for POP operation (HR 3.0, p = 0.02), vaginal vault prolapse operation (HR 4.3, p = 0.01) and POP visits (HR 2.2, p 
ISSN:0001-6349
1600-0412
DOI:10.1111/aogs.14542