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Timing of recurrence after surgery in pelvic organ prolapse

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A Commentary to this article was published on 17 May 2021

Abstract

Objectives

The aim of this study was to determine when women are at risk for recurrent pelvic organ prolapse (POP).

Methods

From 2010 to 2018, all women with symptomatic prolapse, Pelvic Organ Prolapse Quantification (pop-Q) stage 2 in at least one compartment and prolapse surgery were included. The primary outcome measure was POP recurrence. Kaplan-Meier estimates were calculated, survival curves were created, and differences in survival curves were tested with log-rank test. Cox proportional hazard regression was used to investigate associations between recurrence and the number and type of involved compartment(s) and type of surgery.

Results

Forty-six (16.8%) out of 274 patients had POP recurrence during a mean follow-up time of 55 ± 32 months. The mean age was 64 ± 12 years. The hazard of recurrence increased the most in the first 2 years after POP surgery, flattened in years 3 and 4 and remained almost stable in the years thereafter, regardless of the site and number of involved compartment(s). The hazard of recurrence over time seemed the largest when all three compartments were involved. However, there was no statistically significant difference in recurrence between the numbers of (p = 0.65) or in the combination of involved compartments (p = 0.19). There was no difference in POP recurrence over time between prolapse repair with either sacrospinous ligament fixation or vaginal hysterectomy (p = 0.48).

Conclusions

Women are at the highest risk of POP recurrence in the first 2 years after POP surgery independent of the number or combination of involved compartment(s).

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Funding

The project was funded by Tergooi Academie. The Tergooi Academie had no role in the design, analysis, and interpretation of the results of this study.

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Authors and Affiliations

  1. Tergooi, Rijksstraatweg 1, 1261 AN, Blaricum, the Netherlands

    Eveline J Roos

  2. Julius Center for Health sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Huispost Str. 6.131, PO Box 85500, 3508 GA, Utrecht, the Netherlands

    Eveline J Roos & Ewoud Schuit

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  1. Eveline J Roos
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  2. Ewoud Schuit
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Correspondence to Eveline J Roos.

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Roos, E.J., Schuit, E. Timing of recurrence after surgery in pelvic organ prolapse. Int Urogynecol J 32, 2169–2176 (2021). https://doi.org/10.1007/s00192-021-04754-6

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  • DOI: https://doi.org/10.1007/s00192-021-04754-6

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