Risk factors for pelvic organ prolapse repair after hysterectomy.

Abstract:

OBJECTIVE:To estimate the incidence and identify the risk factors for pelvic organ prolapse repair after hysterectomy. METHODS:We conducted a case-control study. We identified 6,214 women who underwent hysterectomy in our gynecology department from 1982 to 2002. Cases (n=114) were women who required pelvic organ prolapse surgery after hysterectomy from January 1982 through December 2005. Controls (n=236) were women randomly selected from the same cohort who did not require pelvic organ surgery during the same period. We performed a univariable and a multivariable analysis among 104 cases and 190 controls to identify the variables associated with prolapse repair after hysterectomy. RESULTS:The incidence of pelvic organ prolapse that required surgical correction after hysterectomy was 1.3 per 1,000 women-years. The risk of prolapse repair was 4.7 times higher in women whose initial hysterectomy was indicated by prolapse and 8.0 times higher if preoperative prolapse grade 2 or more was present. Risk factors included preoperative prolapse grade 2 or more (adjusted odds ratio [OR] 12.6, 95% confidence interval [CI] 4.6-34.7), previous pelvic organ prolapse or urinary incontinence surgery (adjusted OR 7.9, 95% CI 1.3-48.2), history of vaginal delivery (adjusted OR 5.0, 95% CI 1.3-19.7), and sexual activity (adjusted OR 6.2, 95% CI 2.7-14.5). Vaginal hysterectomy was not a risk factor when preoperative prolapse was taken into account (adjusted OR 0.7, 95% CI 0.4-1.1). CONCLUSION:Preoperative pelvic organ prolapse and other factors related to pelvic floor weakness were significantly associated with subsequent pelvic floor repair after hysterectomy. Vaginal hysterectomy was not a risk factor. LEVEL OF EVIDENCE:II.

journal_name

Obstet Gynecol

authors

Dällenbach P,Kaelin-Gambirasio I,Dubuisson JB,Boulvain M

doi

10.1097/01.AOG.0000278567.37925.4e

subject

Has Abstract

pub_date

2007-09-01 00:00:00

pages

625-32

issue

3

eissn

0029-7844

issn

1873-233X

pii

110/3/625

journal_volume

110

pub_type

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