Predictors for Pelvic Organ Prolapse Recurrence After Sacrocolpopexy: A Matched Case-Control Study. Female Pelvic Med Reconstr Surg 2021 Jan 01;27(1):e165-e170
Date
04/14/2020Pubmed ID
32282526DOI
10.1097/SPV.0000000000000874Scopus ID
2-s2.0-85099073308 (requires institutional sign-in at Scopus site) 15 CitationsAbstract
OBJECTIVE: This study aimed to identify risk factors for prolapse recurrence after sacrocolpopexy.
METHODS: This was a retrospective chart review with cross-sectional follow-up survey of 709 patients who underwent sacrocolpopexy of any modality from 2004 to 2014. Cases were defined as those with a composite failure, defined as having subjective bulge symptoms, retreatment, or anatomic prolapse (≥stage 2 prolapse on the Pelvic Organ Prolapse Quantification system). Controls were patients without composite failure. The cases and controls were matched by surgeon and by date of surgery in a 1:4 ratio.
RESULTS: We identified 153 cases and matched them to 487 controls. The overall incidence of prolapse recurrence was 21.6% (95% confidence interval [CI], 18.2%-24.1%). Of the recurrence cases, 34 (22.2%) underwent surgical retreatment; the most common surgical retreatment was a posterior colporrhaphy (n = 16 [47.1%]). On multivariable logistic regression, a preoperative genital hiatus size ≥4 cm (adjusted odds ratio [adjOR], 1.95; 95% CI, 1.18-3.25) and concurrent anterior colporrhaphy (adjOR, 2.11; 95% CI, 1.06-4.18) were associated with increased odds of having a composite failure. Patients who had a concurrent posterior colporrhaphy had lower odds of experiencing a failure (adjOR, 0.62; 95% CI, 0.42-0.94).
CONCLUSIONS: In this large retrospective chart review of women who underwent sacrocolpopexy with a cross-sectional survey follow-up time frame of nearly 7 years, patients with a preoperative genital hiatus of 4 cm or greater and need for concurrent anterior colporrhaphy at the time of their index surgery had higher odds of prolapse recurrence. Conversely, women who underwent a concurrent posterior colporrhaphy had lower odds of a recurrence.
Author List
Chang OH, Davidson ERW, Thomas TN, Paraiso MFR, Ferrando CAAuthor
Emily Davidson MD Assistant Professor in the Obstetrics and Gynecology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AgedCase-Control Studies
Cross-Sectional Studies
Female
Follow-Up Studies
Gynecologic Surgical Procedures
Humans
Middle Aged
Pelvic Organ Prolapse
Recurrence
Retrospective Studies
Sacrum
Secondary Prevention
Vagina