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Age at hysterectomy as a predictor for subsequent pelvic organ prolapse repair

International Urogynecology Journal volume 27, pages 751–755 (2016)Cite this article

Abstract

Introduction and hypothesis

The aim of this study was to investigate the association between patient age at the time of hysterectomy and subsequent pelvic organ prolapse (POP) surgery.

Methods

We gathered data on all benign hysterectomies and POP surgeries performed in Denmark on Danish women from 1977 to 2009 from the Danish National Patient Registry. The cohort consisted of 154,882 hysterectomized women, who were followed up for up to 32 years. Survival analysis for each age group at hysterectomy was performed using Kaplan–Meier product limit methods.

Results

For all hysterectomized women, we found that low age at hysterectomy yielded a lower risk of subsequent POP surgery than did hysterectomy at an older age. This difference diminished after stratification by indication; all non-POP hysterectomies had a low cumulative incidence at 8–11 % at the end of the follow-up period. For all women hysterectomized, the predominant compartment for POP surgery was the posterior. Women hysterectomized when aged over 66 years had a higher proportion of POP surgery in the apical compartment than in the other age groups (p = 0.000).

Conclusion

Our findings indicate that age at hysterectomy only marginally influences the risk of subsequent POP surgery for women hysterectomized for indications other than POP. If POP is the indication for hysterectomy, the risk of undergoing subsequent POP surgery increases substantially.

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References

  1. Rodriguez-Mias NL, Martinez-Franco E, Aguado J, Sanchez E, Amat-Tardiu L (2015) Pelvic organ prolapse and stress urinary incontinence, do they share the same risk factors? Eur J Obstet Gynecol Reprod Biol 190:52–57. doi:10.1016/j.ejogrb.2015.04.015

    Article  PubMed  Google Scholar 

  2. Lowenstein E, Ottesen B, Gimbel H (2014) Incidence and lifetime risk of pelvic organ prolapse surgery in Denmark from 1977 to 2009. Int Urogynecol J 26:49–55. doi:10.1007/s00192-014-2413-y

    Article  PubMed  Google Scholar 

  3. Chow D, Rodriguez LV (2013) Epidemiology and prevalence of pelvic organ prolapse. Curr Opin Urol 3:293–298. doi:10.1097/MOU.0b013e3283619ed0

  4. 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 

  5. 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 

  6. Forsgren C, Lundholm C, Johansson AL, Cnattingius S, Zetterstrom J, Altman D (2012) Vaginal hysterectomy and risk of pelvic organ prolapse and stress urinary incontinence surgery. Int Urogynecol J 23:43–48. doi:10.1007/s00192-011-1523-z

    Article  PubMed  Google Scholar 

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

  8. Lykke R, Blaakaer J, Ottesen B, Gimbel H (2014) 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. doi:10.1007/s00192-014-2490-y

    Article  PubMed  Google Scholar 

  9. Lykke R, Blaakaer J, Ottesen B, Gimbel H (2015) The indication for hysterectomy as a risk factor for subsequent pelvic organ prolapse repair. Int Urogynecol J 26:1661–1665. doi:10.1007/s00192-015-2757-y

    Article  PubMed  Google Scholar 

  10. Lykke R, Blaakaer 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 

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

    PubMed  Google Scholar 

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

    PubMed  Google Scholar 

  13. Kerkhof MH, Hendriks L, Brolmann HA (2009) Changes in connective tissue in patients with pelvic organ prolapse—a review of the current literature. Int Urogynecol J Pelvic Floor Dysfunct 20:461–474. doi:10.1007/s00192-008-0737-1

    CAS  Article  PubMed  Google Scholar 

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Affiliations

  1. Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark

    Rune Lykke & Jan Blaakær

  2. Juliane Marie Centre, Rigshospitalet, Copenhagen, Denmark

    Bent Ottesen

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

    Helga Gimbel

  4. Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark

    Rune Lykke

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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Corresponding author

Correspondence to Rune Lykke.

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Lykke, R., Blaakær, J., Ottesen, B. et al. Age at hysterectomy as a predictor for subsequent pelvic organ prolapse repair. Int Urogynecol J 27, 751–755 (2016). https://doi.org/10.1007/s00192-015-2881-8

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  • DOI: https://doi.org/10.1007/s00192-015-2881-8

Keywords

  • Hysterectomy
  • Kaplan–Meier
  • Pelvic organ prolapse
  • Urogynecology