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Pelvic organ prolapse (POP) surgery among Danish women hysterectomized for benign conditions: age at hysterectomy, age at subsequent POP operation, and risk of POP after hysterectomy

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Abstract

Introduction and hypothesis

The aim of this study was to describe the incidence of pelvic organ prolapse (POP) surgery after hysterectomy from 1977 to 2009, the time interval from hysterectomy to POP surgery, and age characteristics of women undergoing POP surgery after hysterectomy and to estimate the risk of undergoing POP surgery after hysterectomy.

Methods

The study was a population-based registry study. Patient data from 154,882 women hysterectomized for benign conditions in the period from 1977 to 2009 were extracted from the Danish National Patient Registry. Patients were followed up from hysterectomy to POP surgery, death/emigration, or end of study period. An estimate of the hazard of undergoing POP surgery following hysterectomy was calculated. Survival analysis was performed using the Kaplan-Meier product limit method.

Results

The frequency of POP surgery on hysterectomized women was high the first 2 years of the follow-up period with almost 800 women operated yearly. More than one third (n = 2,872) of all women operated for POP were operated less than 5 years after the hysterectomy with a median of 8.6 years. The cumulated incidence of POP surgery after hysterectomy with follow-up of up to 32 years was 12 %; 50 % (n = 5,451) of all POP surgeries were in the posterior compartment. The mean age of women undergoing a first POP surgery after hysterectomy was 60 years.

Conclusions

POP after hysterectomy occurs as a long-term complication of hysterectomy; 12 % of hysterectomized women were operated for POP. They were operated at younger age than non-hysterectomized women and half the POP operations were performed in the posterior compartment.

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Abbreviations

POP:

Pelvic organ prolapse

References

  1. Oliphant SS, Jones KA, Wang L, Bunker CH, Lowder JL (2010) Trends over time with commonly performed obstetric and gynecologic inpatient procedures. Obstet Gynecol 116:926–931. doi:10.1097/AOG.0b013e3181f38599

    Article  PubMed Central  PubMed  Google Scholar 

  2. Lykke R, Blaakær J, Ottesen B, Gimbel H (2013) Hysterectomy in Denmark 1977-2011: changes in rate, indications, and hospitalization. Eur J Obstet Gynecol Reprod Biol 171:333–338. doi:10.1016/j.ejogrb.2013.09.011

    Article  PubMed  Google Scholar 

  3. Altman D, Falconer C, Cnattingius S, Granath F (2008) Pelvic organ prolapse surgery following hysterectomy on benign indications. Am J Obstet Gynecol 198:572.e1–572.e6

    Article  Google Scholar 

  4. Blandon RE, Bharucha AE, Melton LJ 3rd, Schleck CD, Zinsmeister AR, Gebhart JB (2009) Risk factors for pelvic floor repair after hysterectomy. Obstet Gynecol 113:601–608

    Article  PubMed Central  PubMed  Google Scholar 

  5. Forsgren C, Zetterström J, Lopéz A, Altman D (2008) Risk factors for vaginal vault prolapse surgery in postmenopausal hysterectomized women. Menopause 15:1115–1119. doi:10.1097/gme.0b013e31817062a5

    Article  PubMed  Google Scholar 

  6. Dällenbach P, Kaelin-Gambirasio I, Dubuisson JB, Boulvain M (2007) Risk factors for pelvic organ prolapse repair after hysterectomy. Obstet Gynecol 110:625–632

    Article  PubMed  Google Scholar 

  7. Lukanovic A, Drazic K (2010) Risk factors for vaginal prolapse after hysterectomy. Int J Gynaecol Obstet 110:27–30. doi:10.1016/j.ijgo.2010.01.025

    Article  PubMed  Google Scholar 

  8. Blandon RE, Bharucha AE, Melton LJ 3rd, Schleck CD, Babalola EO, Zinsmeister AR et al (2007) Incidence of pelvic floor repair after hysterectomy: a population-based cohort study. Am J Obstet Gynecol 197:664.e1–664.e7

    Article  Google Scholar 

  9. Lidegaard Ø, Hammerum MS (2002) The National Patient Registry as a tool for continuous production and quality control. Ugeskr Laeger 164:4420–4423

  10. Wang J (2005) Smoothing hazard rates. In: Armitage P, Colton T (eds) Encyclopedia of biostatistics. Wiley, New York

  11. Rich JT, Neely JG, Paniello RC, Voelker CC, Nussenbaum B, Wang EW (2010) A practical guide to understanding Kaplan-Meier curves. Otolaryngol Head Neck Surg 143:331–336. doi:10.1016/j.otohns.2010.05.007

    Article  PubMed Central  PubMed  Google Scholar 

  12. Ottesen M (2009) Validity of the registration and reporting of vaginal prolapse surgery. Ugeskr Laeger 171:404–408

  13. Lamers BH, Broekman BM, Milani AL (2011) Pessary treatment for pelvic organ prolapse and health-related quality of life: a review. Int Urogynecol J 22:637–644. doi:10.1007/s00192-011-1390-7

    Article  PubMed Central  PubMed  Google Scholar 

  14. Løwenstein E, Ottesen B, Gimbel H (2014) Incidence and lifetime risk of pelvic organ prolapse surgery in Denmark from 1977 to 2009. Int Urogynecol J. doi:10.1007/s00192-014-2413-y

    Google Scholar 

  15. Dällenbach P, Kaelin-Gambirasio I, Jacob S, Dubuisson JB, Boulvain M (2008) Incidence rate and risk factors for vaginal vault prolapse repair after hysterectomy. Int Urogynecol J Pelvic Floor Dysfunct 19:1623–1629. doi:10.1007/s00192-008-0718-4

    Article  PubMed  Google Scholar 

  16. Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL (1997) Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 89:501–506

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Aarhus University Hospital, Brendstrupgaardsvej 100, 8200, Aarhus N, Denmark

    Rune Lykke & Jan Blaakær

  2. Juliane Marie Centre, Rigshospitalet, Copenhagen, Denmark

    Bent Ottesen

  3. Department of Obstetrics and Gynecology, Nykøbing Falster Hospital, Nykøbing, Denmark

    Helga Gimbel

Authors
  1. Rune Lykke
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  2. Jan Blaakær
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  3. Bent Ottesen
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  4. Helga Gimbel
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Correspondence to Rune Lykke.

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Lykke, R., Blaakær, J., Ottesen, B. et al. Pelvic organ prolapse (POP) surgery among Danish women hysterectomized for benign conditions: age at hysterectomy, age at subsequent POP operation, and risk of POP after hysterectomy. Int Urogynecol J 26, 527–532 (2015). https://doi.org/10.1007/s00192-014-2490-y

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  • DOI: https://doi.org/10.1007/s00192-014-2490-y

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