Long-term follow-up after native tissue repair for pelvic organ prolapse
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- Oversand, S.H., Staff, A.C., Spydslaug, A.E. et al. Int Urogynecol J (2014) 25: 81. doi:10.1007/s00192-013-2166-z
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Introduction and hypothesis
There are large variations in reported frequency of recurrence and subsequent treatment after pelvic organ prolapse (POP) surgery. We hypothesized that native tissue repair entails high subjective satisfaction and good objective results, with low POP reoperation rates and few complications.
The 1-year results of 699 women having had native tissue repair for POP at our urogynecological unit from 2002 to 2005 were evaluated using an internal quality control database. A short-form physician check list for patient subjective and objective outcomes has been routinely used for 1-year controls since 2002, and results are registered longitudinally in the database. Patients’ medical records up to 2012 were reviewed for information on recurrent POP symptoms. A telephone interview was performed to assess POP recurrences potentially treated elsewhere. The cumulative incidence for reoperation was calculated comparing partial with complete (surgical treatment of all three compartments) native tissue repairs.
Subjective satisfaction was stated by 94 % of patients at the 1-year control, and 84 % had stage 0–I in any compartment using the POP Quantification (POP-Q) system. The 5-year reoperation rate was significantly lower in the complete vs. the partial (2.6 % vs. 8.9 %) repair group. Cumulative incidence of reoperation showed a slight but constant increase over the years.
POP surgery using native tissue repair entails low reoperation rates with excellent subjective and objective results and should be the first choice in treating primary POP, providing use of adequate surgical technique.