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. 2008 May;198(5):555.e1-5.
doi: 10.1016/j.ajog.2008.01.051. Epub 2008 Mar 20.

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

Mary Anna Denman  1 , W Thomas Gregory, Sarah H Boyles, Virginia Smith, S Renee Edwards, Amanda L Clark
Affiliations

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

Mary Anna Denman et al. Am J Obstet Gynecol. 2008 May.

Abstract

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.

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Comment in

  • Reoperation rate following prolapse surgery.
    Kapoor DS, Freeman RM. Kapoor DS, et al. Am J Obstet Gynecol. 2009 Feb;200(2):e15; author reply e15. doi: 10.1016/j.ajog.2008.06.049. Epub 2008 Aug 21. Am J Obstet Gynecol. 2009. PMID: 18718567 No abstract available.