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International Urogynecology Journal
Erschienen in: International Urogynecology Journal 1/2018

18.09.2017 | Review Article

Risk factors for prolapse recurrence: systematic review and meta-analysis

verfasst von: Talia Friedman, Guy D. Eslick, Hans Peter Dietz

Erschienen in: International Urogynecology Journal | Ausgabe 1/2018

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Abstract

Introduction and hypothesis

Female pelvic organ prolapse (POP) is a common condition, with a lifetime risk for surgery of 10–20%. Prolapse procedures are known to have a high reoperation rate. It is assumed that etiological factors for POP may also be risk factors for POP recurrence after surgery. There are few reviews available evaluating risk factors for prolapse and recurrence or recently updated meta-analysis on this topic. Our aim was to perform a systematic review and quantitative meta-analysis to determine risk factors for prolapse recurrence after reconstructive surgery.

Methods

Four electronic databases (MEDLINE, PubMed, EMBASE, and Google Scholar) were searched between 1995 and 1 January 2017, with no language restrictions.

Results

Twenty-five studies met inclusion criteria for a total of 5082 patients with an average recurrence rate of 36%. Variables on which a meta-analysis could be performed were body mass index (BMI) (n = 12), age (n = 11), preoperative stage (n = 9), levator avulsion (n = 8), parity (n = 8), constipation/straining (n = 6), number of compartments involved (n = 4), prior hysterectomy (n = 4), familiy history (n = 3), and several other predictors evaluated in only three studies. The following meta- analyses identified significant predictors: levator avulsion [odds ratio (OR) 2.76, P < 0.01], preoperative stage 3–4 (OR 2.11, P < 0.001), family history (OR 1.84, P = 0.006), and hiatal area (OR 1.06/cm2, P = 0.003).

Conclusions

Levator avulsion, prolapse stage, and family history are significant risk factors for prolapse recurrence.
Literatur
1.
Dietz H. The aetiology of prolapse. Int Urogynecol J. 2008;19(10):1323.CrossRef
2.
Schaffer JI, Wai CY, Boreham MK. Etiology of pelvic organ prolapse. Clin Obstet Gynecol. 2005;48(3):639–47.CrossRefPubMed
3.
Fritel X, Varnoux N, Zins M, Breart G, Ringa V. Symptomatic pelvic organ prolapse at midlife, quality of life, and risk factors. Obstet Gynecol. 2009;113(3):609.CrossRefPubMedPubMedCentral
4.
Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL. Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol. 1997;89(4):501–6.CrossRefPubMed
5.
Smith FJ, Holman CAJ, Moorin RE, Tsokos N. Lifetime risk of undergoing surgery for pelvic organ prolapse. Obstet Gynecol. 2010;116(5):1096–100.CrossRefPubMed
6.
Benson JT, Lucente V, McClellan E. Vaginal versus abdominal reconstructive surgery for the treatment of pelvic support defects: a prospective randomized study with long-term outcome evaluation. Am J Obstet Gynecol. 1996;175(6):1418–22.CrossRefPubMed
7.
Diwadkar GB, Barber MD, Feiner B, Maher C, Jelovsek JE. Complication and reoperation rates after apical vaginal prolapse surgical repair: a systematic review. Obstetrics & Gynecology. 2009;113(2, Part 1):367–73.CrossRef
8.
Denman MA, Gregory WT, Boyles SH, Smith V, Edwards SR, Clark AL. Reoperation 10 years after surgically managed pelvic organ prolapse and urinary incontinence. Am J Obstet Gynecol. 2008;198(5):555.e551–555. e555CrossRef
9.
Salvatore S, Siesto G, Serati M. Risk factors for recurrence of genital prolapse. Curr Opin Obstet Gynecol. 2010;22(5):420–4.CrossRefPubMed
10.
Vergeldt TF, Weemhoff M, IntHout J, Kluivers KB. Risk factors for pelvic organ prolapse and its recurrence: a systematic review. Int Urogynecol J. 2015;26(11):1559.CrossRefPubMedPubMedCentral
11.
Whiteside JL, Weber AM, Meyn LA, Walters MD. Risk factors for prolapse recurrence after vaginal repair. Am J Obstet Gynecol. 2004;191(5):1533–8.CrossRefPubMed
12.
Salvatore S, Athanasiou S, Digesu GA, Soligo M, Sotiropoulou M, Serati M, et al. Identification of risk factors for genital prolapse recurrence. Neurourol Urodyn. 2009;28(4):301–4.CrossRefPubMed
13.
Diez-Itza I, Aizpitarte I, Becerro A. Risk factors for the recurrence of pelvic organ prolapse after vaginal surgery: a review at 5 years after surgery. Int Urogynecol J. 2007;18(11):1317.CrossRef
14.
Jeon MJ, Chung SM, Jung HJ, Kim SK, Bai SW. Risk factors for the recurrence of pelvic organ prolapse. Gynecol Obstet Investig. 2008;66(4):268–73.CrossRef
15.
Maher C, Baessler K, Glazener C, Adams E, Hagen S. Surgical management of pelvic organ prolapse in women: a short version Cochrane review. Neurourol Urodyn. 2008;27(1):3–12.CrossRefPubMed
16.
Maher CM, Feiner B, Baessler K, Glazener CM. Surgical management of pelvic organ prolapse in women: the updated summary version Cochrane review. Int Urogynecol J. 2011;22(11):1445–57.CrossRefPubMed
17.
Sze H, Karram MM. Transvaginal repair of vault prolapse: a review. Obstet Gynecol. 1997;89(3):466–75.CrossRefPubMed
18.
Barski D, Otto T, Gerullis H. Systematic review and classification of complications after anterior, posterior, apical, and total vaginal mesh implantation for prolapse repair. Surg Technol Int. 2014;24:217–24.PubMed
19.
Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097.CrossRefPubMedPubMedCentral
20.
DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986;7(3):177–88.CrossRefPubMed
21.
Higgins J, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses [journal article as teaching resource, deposited by John Flynn]. Br Med J. 2003;327:557–60.CrossRef
22.
23.
Orwin RG. A fail-safe N for effect size in meta-analysis. J Educ Stat. 1983;8(2):157–9.CrossRef
24.
Kenton K, Sadowski D, Shott S, Brubaker L. A comparison of women with primary and recurrent pelvic prolapse. Am J Obstet Gynecol. 1999;180(6):1415–8.CrossRefPubMed
25.
Goldberg RP, Koduri S, Lobel RW, Culligan PJ, Tomezsko JE, Winkler HA, et al. Protective effect of suburethral slings on postoperative cystocele recurrence after reconstructive pelvic operation. Am J Obstet Gynecol. 2001;185(6):1307–13.CrossRefPubMed
26.
Clark AL, Gregory T, Smith VJ, Edwards R. Epidemiologic evaluation of reoperation for surgically treated pelvic organ prolapse and urinary incontinence. Am J Obstet Gynecol. 2003;189(5):1261–7.CrossRefPubMed
27.
Tegerstedt G, Hammarström M. Operation for pelvic organ prolapse: a follow-up study. Acta Obstet Gynecol Scand. 2004;83(8):758–63.CrossRefPubMed
28.
Vakili B, Zheng YT, Loesch H, Echols KT, Franco N, Chesson RR. Levator contraction strength and genital hiatus as risk factors for recurrent pelvic organ prolapse. Am J Obstet Gynecol. 2005;192(5):1592–8.CrossRefPubMed
29.
Fialkow MF, Newton KM, Weiss NS. Incidence of recurrent pelvic organ prolapse 10 years following primary surgical management: a retrospective cohort study. Int Urogynecol J. 2008;19(11):1483–7.CrossRef
30.
Dietz H, Chantarasorn V, Shek K. Levator avulsion is a risk factor for cystocele recurrence. Ultrasound Obstet Gynecol. 2010;36(1):76–80.CrossRefPubMed
31.
Model AN, Shek KL, Dietz HP. Levator defects are associated with prolapse after pelvic floor surgery. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2010;153(2):220–3.CrossRef
32.
Morgan DM, Larson K, Lewicky-Gaupp C, Fenner DE, DeLancey JO. Vaginal support as determined by levator ani defect status 6 weeks after primary surgery for pelvic organ prolapse. Int J Gynecol Obstet. 2011;114(2):141–4.CrossRef
33.
Weemhoff M, Vergeldt TF, Notten K, Serroyen J, Kampschoer PH, Roumen FJ. Avulsion of puborectalis muscle and other risk factors for cystocele recurrence: a 2-year follow-up study. Int Urogynecol J. 2012;23(1):65–71.CrossRefPubMed
34.
Wong V, Shek K, Rane A, Goh J, Krause H, Dietz H. Is levator avulsion a predictor of cystocele recurrence following anterior vaginal mesh placement? Ultrasound Obstet Gynecol. 2013;42(2):230–4.CrossRefPubMed
35.
Kawasaki A, Corey EG, Laskey RA, Weidner AC, Siddiqui NY, Wu JM. Obesity as a risk for the recurrence of anterior vaginal wall prolapse after anterior colporrhaphy. J Reprod Med. 2012;58(5–6):195–9.
36.
Edenfield AL, Amundsen CL, Weidner AC, Wu JM, George A, Siddiqui NY. Vaginal prolapse recurrence after uterosacral ligament suspension in normal-weight compared with overweight and obese women. Obstet Gynecol. 2013;121(3):554–9.CrossRefPubMed
37.
Crosby E, Dewald S, Fenner D, Delancey J, Morgan D. The effect of major levator ani defects on postoperative outcomes after primary surgery for pelvic organ prolapse. In: International urogynecology journal. London: Springer; 2014. p. S44–S45.
38.
Rodrigo N, Wong V, Shek KL, Martin A, Dietz HP. The use of 3-dimensional ultrasound of the pelvic floor to predict recurrence risk after pelvic reconstructive surgery. Aust N Z J Obstet Gynaecol. 2014;54(3):206–11.CrossRefPubMed
39.
Vergeldt T, Notten K, Weemhoff M, Kuijk S, Mulder F, Beets-Tan R, et al. Levator hiatal area as a risk factor for cystocele recurrence after surgery: a prospective study. BJOG Int J Obstet Gynaecol. 2015;122(8):1130–7.CrossRef
40.
Vergeldt TF, van Kuijk SM, Notten KJ, Kluivers KB, Weemhoff M. Anatomical cystocele recurrence: development and internal validation of a prediction model. Obstet Gynecol. 2016;127(2):341–7.CrossRefPubMed
41.
Abdul Jalil S, Guzmán Rojas R, Dietz HP. Does it matter whether levator avulsion is diagnosed pre-or postoperatively? Ultrasound Obstet Gynecol. 2016;48(4):516–9.CrossRefPubMed
42.
Rappa C, Saccone G. Recurrence of vaginal prolapse after total vaginal hysterectomy with concurrent vaginal uterosacral ligament suspension: comparison between normal-weight and overweight women. Am J Obstet Gynecol. 2016;215(5):601.e1–-e4.CrossRef
43.
Turner L, Lavelle E, Lowder JL, Shepherd JP. The impact of obesity on intraoperative complications and prolapse recurrence after minimally invasive sacrocolpopexy. Female Pelvic Med Reconstr Surg. 2016;22(5):317–23.CrossRefPubMed
44.
Altman DG. Systematic reviews of evaluations of prognostic variables. BMJ Br Med J. 2001;323(7306):224.CrossRef
45.
Salvatore S, Siesto G, Rizk DE. Definition of recurrence of pelvic organ prolapse: is it really important? Berlin: Springer; 2011.
46.
Abdool Z, Dietz H, Lindeque B. A comparison of functional pelvic floor anatomy in white and black south african women with symptomatic pelvic organ prolapse. Neurourol Urodyn. 2014;33:910–1.
47.
Cheung RY, Chan SS, Yiu A, Lee L. Prevalence of pelvic organ prolapse in different compartments in symptomatic Chinese women. ICS conference abstract number 199. Parity 2014;69:11.10.
48.
Dietz HP, Franco AV, Shek KL, Kirby A. Avulsion injury and levator hiatal ballooning: two independent risk factors for prolapse? An observational study. Acta Obstet Gynecol Scand. 2012;91(2):211–4.CrossRefPubMed
49.
Dietz H, Bhalla R, Chantarasorn V, Shek K. Avulsion of the puborectalis muscle is associated with asymmetry of the levator hiatus. Ultrasound Obstet Gynecol. 2011;37(6):723–6.CrossRefPubMed
50.
Abdool Z, Shek KL, Dietz HP. The effect of levator avulsion on hiatal dimension and function. Am J Obstet Gynecol. 2009;201(1):89.e81-89. e85CrossRef
51.
Dietz H, Simpson J. Levator trauma is associated with pelvic organ prolapse. BJOG Int J Obstet Gynaecol. 2008;115(8):979–84.CrossRef
52.
Young N, Atan I, Dietz H. Obesity: how much does it matter for female pelvic organ prolapse? BJOG Int J Obstet Gynaecol. 2015;122:391.
Metadaten
Titel
Risk factors for prolapse recurrence: systematic review and meta-analysis
verfasst von
Talia Friedman
Guy D. Eslick
Hans Peter Dietz
Publikationsdatum
18.09.2017
Verlag
Springer London
Erschienen in
International Urogynecology Journal / Ausgabe 1/2018
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-017-3475-4

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