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Pelvic organ prolapse recurrence in young women undergoing vaginal and abdominal colpopexy

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Abstract

Introduction and hypothesis

While pelvic organ prolapse (POP) recurrence is believed to increase over time, outcomes of young women who undergo POP surgery are unclear. We hypothesized POP recurrence incidence among women <49 years would be higher after vaginal versus abdominal colpopexy.

Methods

This is a retrospective cohort study with a cross-sectional survey of women 18–49 years who underwent primary POP surgery from January 2003 to September 2013. Patients were identified by CPT codes for vaginal and abdominal colpopexy. POP recurrence was defined as vaginal bulge symptoms, POP retreatment (pessary or surgery) or both. Validated questionnaires were used to assess pelvic floor symptoms, patient satisfaction and improvement.

Results

Three hundred thirty-three women met the criteria. Mean age was 43 (+ 5.3) years; 29.1% (97) had an abdominal colpopexy and 70.9% (236) had a vaginal colpopexy. The recurrence incidence overall was 32.0% (31) in the abdominal group and 24.2% (57) in the vaginal group (p = 0.15), with a 10.3% (10) retreatment incidence in the abdominal group and 5.9% (14) in the vaginal group (p = 0.16). Forty-five percent (149) responded to the survey at a median time of 7.9 (3.1–15.2) years since surgery. The overall recurrence incidence in respondents was 13.7% (7) in the abdominal group and 15.3% (15) in the vaginal group (p = 0.80), with a retreatment incidence of 5.9% (3) in the abdominal and 5.2% (5) in the vaginal group (p = 0.85).

Conclusions

One in four young women experienced subjective POP recurrence and/or retreatment, but only 5–10% underwent retreatment. There does not appear to be a difference in the incidence of recurrence between vaginal and abdominal colpopexy.

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Authors and Affiliations

  1. Section of Urogynecology and Reconstructive Pelvic Surgery, Obstetrics, Gynecology & Women’s Health Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue A81, Cleveland, OH, 44195, USA

    Lisa C. Hickman, Emily R. W. Davidson, Mark D. Walters & Cecile A. Ferrando

  2. Case Western Reserve University School of Medicine, Cleveland, OH, USA

    Misha C. Tran

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  1. Lisa C. Hickman
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  2. Misha C. Tran
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  3. Emily R. W. Davidson
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  4. Mark D. Walters
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  5. Cecile A. Ferrando
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Correspondence to Lisa C. Hickman.

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Hickman, L.C., Tran, M.C., Davidson, E.R.W. et al. Pelvic organ prolapse recurrence in young women undergoing vaginal and abdominal colpopexy. Int Urogynecol J 31, 2661–2667 (2020). https://doi.org/10.1007/s00192-019-04139-w

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  • DOI: https://doi.org/10.1007/s00192-019-04139-w

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