Skip to main content
Log in

Incidence of pelvic organ prolapse repair subsequent to hysterectomy: a comparison between radical hysterectomy and total abdominal hysterectomy

  • Original Article
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

Abstract

Introduction and hypothesis

The aim of this study was to compare the incidence of subsequent pelvic organ prolapse (POP) repair in women following radical hysterectomy versus total abdominal hysterectomy.

Methods

From the Danish National Patient Registry, we collected data on all radical hysterectomies, all total abdominal hysterectomies, and all POP operations performed in Denmark from 1 January 1977 to 31 December 2009. We excluded patients with prior POP repair, POP diagnosis, or concomitant POP repair at hysterectomy. We analyzed the incidence of POP surgery using Kaplan–Meier curves and hazard ratio (HR).

Results

In all, 5279 women underwent radical hysterectomy, and 63 of these underwent subsequent POP surgery. In the same period, 149,920 women underwent total abdominal hysterectomy, and 6107 of these had POP surgery subsequent to the hysterectomy. The cumulative incidence of POP surgery was significantly lower for radical hysterectomy than for abdominal hysterectomy—3.4 % and 9.5 %, respectively, at the end of the study period, yielding a crude HR of 0.36 and an adjusted HR of 0.40 in favor of the radical hysterectomy. The distribution of POP operations in the defined compartments was the same for the two types of hysterectomy.

Conclusions

This study found a significantly lower incidence of subsequent POP operations among women who undergo radical hysterectomy than total abdominal hysterectomy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Lykke R, Blaakær J, Ottesen B, Gimbel H. Hysterectomy in Denmark 1977–2011: changes in rate, indications, and hospitalization. Eur J Obstet Gynecol Reprod Biol. 2013;171:333–8. doi:10.1016/j.ejogrb.2013.09.011.

    Article  PubMed  Google Scholar 

  2. Ware RA, van Nagell JR. Radical hysterectomy with pelvic lymphadenectomy: indications, technique, and complications. Obstet Gynecol Int. 2010. doi:10.1155/2010/587610.

    PubMed  PubMed Central  Google Scholar 

  3. Shalom DF, Lin SN, O’Shaughnessy D, et al. Effect of prior hysterectomy on the anterior and posterior vaginal compartments of women presenting with pelvic organ prolapse. Int J Gynecol Obstet. 2012;119:274–6. doi:10.1016/j.ijgo.2012.06.014.

    Article  Google Scholar 

  4. Altman D, Falconer C, Cnattingius S, Granath F. Pelvic organ prolapse surgery following hysterectomy on benign indications. Am J Obstet Gynecol. 2008;198:572.e1–6. doi:10.1016/j.ajog.2008.01.012.

    Article  Google Scholar 

  5. Blandon RE, Bharucha AE, Melton 3rd LJ, et al. Incidence of pelvic floor repair after hysterectomy: A population-based cohort study. Am J Obstet Gynecol. 2007;197:664.e1–7. doi:10.1016/j.ajog.2007.08.064.

    Article  Google Scholar 

  6. Lykke R, Blaakær J, Ottesen B, Gimbel H. 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. 2015;26:527–32. doi:10.1007/s00192-014-2490-y.

    Article  PubMed  Google Scholar 

  7. Lykke R, Blaakær J, Ottesen B, Gimbel H. The indication for hysterectomy as a risk factor for subsequent pelvic organ prolapse repair. Int Urogynecol J. 2015;26:1661–5. doi:10.1007/s00192-015-2757-y.

    Article  PubMed  Google Scholar 

  8. Chow D, Rodriguez LV. Epidemiology and prevalence of pelvic organ prolapse. Curr Opin Urol. 2013;23:293–8. doi:10.1097/MOU.0b013e3283619ed0.

    Article  PubMed  Google Scholar 

  9. Axelsen SM, Bek KM, Petersen LK. Urodynamic and ultrasound characteristics of incontinence after radical hysterectomy. Neurourol Urodyn. 2007;26:794–9. doi:10.1002/nau.20431.

    Article  PubMed  Google Scholar 

  10. Ottesen M. Validity of the registration and reporting of vaginal prolapse surgery. Ugeskr Laeger. 2009;171:404–8.

    PubMed  Google Scholar 

  11. Lidegaard O, Hammerum MS. The National Patient Registry as a tool for continuous production and quality control. Ugeskr Laeger. 2002;164:4420–3.

    PubMed  Google Scholar 

  12. Wang J-L. Smoothing Hazard Rates. Encycl Biostat. 2005. doi:10.1002/0470011815.b2a11069.

    Google Scholar 

  13. Fuglsang K, Petersen LK, Blaakaer J. Addressing challenges in future surveillance after surgery for early-stage cervical cancer. Int J Gynecol Cancer. 2015;25:309–14. doi:10.1097/IGC.0000000000000346.

    Article  PubMed  Google Scholar 

  14. Dahl L, Wittrup I, Væggemose U, et al. Life after gynecologic cancer--a review of patients quality of life, needs, and preferences in regard to follow-up. Int J Gynecol Cancer. 2013;23:227–34. doi:10.1097/IGC.0b013e31827f37b0.

    Article  PubMed  Google Scholar 

  15. Wiebe E, Denny L, Thomas G. Cancer of the cervix uteri. Int J Gynaecol Obstet. 2012;119(Suppl):S100–9. doi:10.1016/S0020-7292(12)60023-X.

    Article  PubMed  Google Scholar 

  16. Marin F, Plesca M, Bordea CI, et al. Types of radical hysterectomies: from Thoma Ionescu and Wertheim to present day. J Med Life. 2014;7:172–6.

    CAS  PubMed  PubMed Central  Google Scholar 

  17. Dursun P, Gultekin M, Ayhan A. The history of radical hysterectomy. J Low Genit Tract Dis. 2011;15:235–45. doi:10.1097/LGT.0b013e31820eb038.

    Article  PubMed  Google Scholar 

  18. Løwenstein E, Ottesen B, Gimbel H. Incidence and lifetime risk of pelvic organ prolapse surgery in Denmark from 1977 to 2009. Int Urogynecol J. 2015;26:49–55. doi:10.1007/s00192-014-2413-y.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Rune Lykke.

Ethics declarations

Financial disclaimer

None

Conflicts of interest

None

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lykke, R., Blaakær, J., Ottesen, B. et al. Incidence of pelvic organ prolapse repair subsequent to hysterectomy: a comparison between radical hysterectomy and total abdominal hysterectomy. Int Urogynecol J 28, 745–749 (2017). https://doi.org/10.1007/s00192-016-3173-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00192-016-3173-7

Keywords

Navigation