A comparison of women with primary and recurrent pelvic prolapse☆,☆☆
Section snippets
Material and methods
The charts of all women who underwent reconstructive surgery for pelvic organ prolapse between May 1995 and February 1997 at our tertiary care referral practice were reviewed. All women completed a comprehensive urogynecologic history and a physical examination, with the maximum extent of pelvic organ prolapse quantified according to the standardized Pelvic Organ Prolapse Quantitation system.2 Unless the vagina was completely everted in the supine position, all women were assessed in the
Results
One hundred eighty-one consecutive women, who ultimately underwent surgery for symptomatic pelvic organ prolapse at our tertiary care referral practice, formed the study population. Women who were treated nonsurgically were not included. Study women had a mean age of 61 years and a mean vaginal parity of 3.3 children. The majority of the women were white (87%) and postmenopausal (86%). Thirty-seven women (20%) had stage 4 pelvic organ prolapse, 88 women (49%) had stage 3, and 55 women (30%) had
Comment
Recurrent pelvic organ prolapse has been described as a “gynecologic tragedy” in which “the patient deserves empathy and understanding and above all a very sophisticated reevaluation by the best and most experienced operator available.”6 Certainly, no pelvic surgeon would disagree with this assessment. This study challenges the current practice of stratifying preoperative evaluation of pelvic organ prolapse and limiting comprehensive evaluation to those patients with recurrent pelvic organ
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Cited by (38)
Genital hiatus size is associated with and predictive of apical vaginal support loss
2016, American Journal of Obstetrics and GynecologyRates of colpopexy and colporrhaphy at the time of hysterectomy for prolapse
2016, American Journal of Obstetrics and GynecologyCitation Excerpt :In fact, national guidelines consider hysterectomy alone to be inadequate treatment for POP.5 Despite this, anterior and posterior colporrhaphy are frequently performed without a colpopexy procedure4,6 and hysterectomy alone is often utilized for treatment of prolapse.7 Our primary objectives were to describe how often concomitant prolapse procedures are used at the time of hysterectomy for POP, to identify those factors associated with use of colporrhaphy and colpopexy (apical suspension) at the time of hysterectomy for POP, and to identify the influence of surgical complexity on perioperative complication rates.
Long-term results of prolapse recurrence and functional outcome after vaginal hysterectomy
2013, International Journal of Gynecology and ObstetricsCitation Excerpt :Similarly, previous prolapse surgery did not seem to be a risk factor for recurrent prolapse. Kenton et al. [14] found that the incidence and severity of pelvic organ prolapse did not differ significantly between women with primary prolapse and women who had prior prolapse surgery. They also found that women with recurrent pelvic organ prolapse were more likely to have had a prior hysterectomy performed for indications other than prolapse.
Investigation of correlation between diameters of pelvic inlet and outlet planes and female pelvic floor dysfunction
2011, European Journal of Obstetrics and Gynecology and Reproductive BiologyCitation Excerpt :FPFD mainly including pelvic organ prolapse (POP) and stress urinary incontinence (SUI) is a common disorder seriously affecting the daily lives of women. Although the precise pathogenesis of this disorder is still unknown, it is presently believed that its onset is related to pregnancy, delivery, obesity, drugs, estrogen deficiency, pelvic floor surgery and nerve injury [1–3]. Some studies suggested that pelvic incidence larger than 62° was one of the risk factors for POP [4–7].
Connective tissue and prolapse genesis
2010, Gynecologie Obstetrique et FertiliteAnatomic outcomes of vaginal mesh procedure (Prolift) compared with uterosacral ligament suspension and abdominal sacrocolpopexy for pelvic organ prolapse: a Fellows' Pelvic Research Network study
2009, American Journal of Obstetrics and Gynecology