Risk factors for recurrence of pelvic organ prolapse after vaginal surgery among Ugandan women: a prospective cohort study

Abstract Introduction and hypothesis This study was aimed at determining the recurrence rate and risk factors for the recurrence of pelvic organ prolapse (POP), at 1 year post-vaginal reconstructive surgery in a resource-limited setting. Methods We enrolled women who underwent vaginal surgery for POP at the urogynecology unit of Mbarara Regional Referral Hospital (MRRH) in southwestern Uganda between December 2018 and February 2020. The surgeries that were performed include anterior colporrhaphy for cystocele, posterior colporrhaphy for rectocele, vaginal hysterectomy with vault suspension for uterine prolapse, and cervicopexy in those with uterine prolapse where uterine-sparing surgery was desired. The women were followed up for a period of 1 year after surgery. Pelvic examinations in lithotomy position under maximum strain were carried out to assess for recurrence using the Pelvic Organ Quantification (POP-Q) system. Recurrence was defined as a prolapse of ≥POP-Q stage II. Descriptive analyses and multivariate log binomial regression were performed to determine risk factors for recurrence. Results Of the 140 participants enrolled, 127 (90.7%) completed the follow-up at 1 year. The recurrence rate was 25.2% (32 out of 127). Most (56.3%) of the recurrences occurred in the anterior compartment and in the same site previously operated. Women aged <60 years (RR = 2.34; 95% CI: 1.16–4.72; p = 0.018) and those who had postoperative vaginal cuff infection (RR = 2.54; 95% CI: 1.5–4.3; p = 0.001) were at risk of recurrence. Conclusion Recurrence of POP was common. Younger women, and those with postoperative vaginal cuff infection, were more likely to experience recurrent prolapse after vaginal repair.

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Pelvic Organ Prolapse in Countries of Different Economy: A Systematic Review

Nepal Journal of Obstetrics and Gynaecology ◽

10.3126/njog.v14i2.28436 ◽

2019 ◽

Vol 14 (2) ◽

pp. 7-21

Author(s):

Shishir Paudel ◽

Anisha Chalise ◽

Ganesh Dangal ◽

Tulsi Ram Bhandari ◽

Gehanath Baral

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Pelvic Organ Prolapse ◽

Uterine Prolapse ◽

National Income ◽

Significant Risk ◽

Pelvic Organ ◽

Reference List ◽

Medical Subject Headings ◽

Pubmed Database

Aims: This review was done to identify the reported prevalence rate of pelvic organ prolapse among the different world populations. Methods: Systematic review of Pelvic Organ Prolapse (POP) using the PRISMA checklist; PubMed database was searched on reportingthe prevalence of POP and its management measures in January 2020. Medical Subject Headings (MeSH) like "Pelvic Organ Prolapse"OR "Uterine Prolapse" OR “Vaginal Wall Prolapse” OR "Cystocele"AND "Prevalence [key word/s]" were used. Additional articles were identified through the reference list of the retrieved articles. Results: Out of 91 screened articles, 46 full articles were eligible and only 15 satisfied by selection criteria for the systematic review.The methodological score rated for the quality of studies is 4.5±1.7 (range=2-7) out of 8 points. The mean prevalence of POP diagnosis was 40%; with 42.44% in low and lower-middle-income countries,and 35.56%in upper-middle and high-income countries. Increasing age and parity, body mass indexand fetal macrosomia were found to be the significant risk factors irrespective of the country’s economy. Conclusions:The low and lower-income countries have almost twice the burden of prolapse than the countries of the higher economy. The major risk factors associated with prolapse remain common in all countries irrespective of national income or development.

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Clinical epidemiological study of uterine prolapse

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20185287 ◽

2018 ◽

Vol 8 (1) ◽

pp. 79

Author(s):

Parvathavarthini K. ◽

Vanusha A.

Keyword(s):

Risk Factors ◽

Pelvic Organ Prolapse ◽

Social Issues ◽

Uterine Prolapse ◽

Epidemiological Data ◽

Pelvic Organ ◽

Life Threatening ◽

The Mean ◽

Awareness Programme

Background: Pelvic organ prolapse is one of the common gynaecological problem in India among the parous and aged women. Though the pelvic organ prolapse is not life threatening if left untreated it can lead to many social issues and also it reduces the quality of life of a woman. Thus, this study aims at generating epidemiological data on uterine prolapse in a clinical setting and identifying its risk factors so that appropriate measures can be taken to prevent the same.Methods: It was a descriptive case control study. Using a study proforma the required information was collected from the patients admitted with uterine prolapse (case) and from amongst the patient’s attendees of Gynaecology ward (control). Obtained data were compared and analyzed using appropriate statistical methods.Results: Uterine prolapse contributes to about 5.9% of the total gynecological patients admitted during the study period. The mean age of presentation with uterine prolapse was 50.1years the mean number of deliveries was higher in case compared to the control with the mean of 4 deliveries. Out of 130 patients, only 13.9% of them had institutional delivery while the others had home delivery.Conclusions: Uterine prolapse is strongly associated with age, parity and place of delivery. As the risk factors for uterine prolapse are easily preventable public health awareness programme must be conducted on its risk factors there by reducing the incidence of prolapse and decreasing the morbidity caused by it.

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Risk factors for the recurrence of pelvic organ prolapse after vaginal surgery: a review at 5 years after surgery

International Urogynecology Journal ◽

10.1007/s00192-007-0321-0 ◽

2007 ◽

Vol 18 (11) ◽

pp. 1317-1324 ◽

Cited By ~ 99

Author(s):

I. Diez-Itza ◽

I. Aizpitarte ◽

A. Becerro

Keyword(s):

Risk Factors ◽

Pelvic Organ Prolapse ◽

Vaginal Surgery ◽

Pelvic Organ

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Risk factors for stress urinary incontinence after native-tissue vaginal repair of pelvic organ prolapse

International Journal of Gynecology & Obstetrics ◽

10.1002/ijgo.12443 ◽

2018 ◽

Vol 141 (3) ◽

pp. 349-353 ◽

Cited By ~ 3

Author(s):

Matteo Frigerio ◽

Stefano Manodoro ◽

Stefania Palmieri ◽

Federico Spelzini ◽

Rodolfo Milani

Keyword(s):

Risk Factors ◽

Urinary Incontinence ◽

Pelvic Organ Prolapse ◽

Stress Urinary Incontinence ◽

Pelvic Organ ◽

Vaginal Repair ◽

Native Tissue

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Clinical risk factors for recurrence of pelvic organ prolapse after primary native tissue prolapse repair

Wiener klinische Wochenschrift ◽

10.1007/s00508-021-01861-8 ◽

2021 ◽

Author(s):

Barbara Bodner-Adler ◽

Klaus Bodner ◽

Greta Carlin ◽

Oliver Kimberger ◽

Julian Marschalek ◽

...

Keyword(s):

Risk Factors ◽

Pelvic Organ Prolapse ◽

Postoperative Recurrence ◽

Pelvic Organ ◽

Prolapse Surgery ◽

Short Report ◽

Prolapse Repair ◽

Native Tissue ◽

Potential Risk Factors ◽

Risk Factors For Recurrence

Summary Objective To define potential risk factors for recurrence of prolapse. Methods This short report included all women who presented with recurrence of prolapse as well as without any recurrence signs after a vaginal approach of native tissue prolapse repair at an urogynecological center in Austria. Results A total of 124 recurrence cases and 64 women with no signs of recurrence after their index prolapse surgery were included. Multivariate analysis identified advanced preoperative POP‑Q stage (pelvic organ prolapse-quantification) as an independent risk factor for postoperative recurrence of prolapse (p = 0.045). Conclusion Initial proper preoperative counseling is of particular importance to modulate patients’ expectations after prolapse surgery.

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