Effect of pregnancy on uterine-sparing pelvic organ prolapse repair

Abstract

Introduction and hypothesis: The impact of pregnancy on pelvic organ prolapse following surgical repair is not well understood. We describe five cases of pregnancy following uterine-sparing surgical treatment of pelvic organ prolapse. We analyzed the changes in women's Pelvic Organ Prolapse Quantification (POP-Q) scores. We hypothesized there would be significant improvement in anterior and apical prolapse after surgery and no recurrence of prolapse after pregnancy.

Methods: We performed a retrospective review of the electronic medical record for cases of uterine-sparing apical suspension performed between January 2004 and December 2012 at Boston Medical Center. Student's t-test for paired design was used to compare the change in POP-Q score at points Aa, Ba and C obtained at preoperative, postoperative and postpartum visits.

Results: Subjects in our series demonstrated significant improvement in their prolapse at all POP-Q points of interest between the pre- and postoperative visits, particularly at point C. There was a slight increase in POP-Q score from the postoperative visit to the postpartum visit, but this change was not statistically significant.

Conclusions: Our findings are consistent with previous literature, suggesting that the results of uterine-sparing apical prolapse repair are maintained after pregnancy. Women may be counseled to consider surgical prolapse repair even if they have not completed childbearing.

Keywords: Pelvic organ prolapse; Pregnancy; Sacrohysteropexy; Uterine preservation.