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Erschienen in: International Urogynecology Journal 8/2010

01.08.2010 | Original Article

Years from menopause-to-surgery is a major factor in the post-operative subjective outcome for pelvic organ prolapse

verfasst von: Ki Hoon Ahn, Tak Kim, Jun Young Hur, Sun Haeng Kim, Kyu Wan Lee, Young Tae Kim

Erschienen in: International Urogynecology Journal | Ausgabe 8/2010

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Abstract

Introduction and hypothesis

The purpose of the current study was to determine the main factors associated with post-operative subjective outcome in post-menopausal patients with pelvic organ prolapse.

Methods

Ninety-four women were selected among patients who underwent surgery for grade 3 or 4 prolapse. The outcome was evaluated by the Patient Global Impression of Improvement (PGI-I) scale. Multivariate ordinal regression analysis was performed.

Results

The number of patients with improvement (1 or 2 on the PGI-I scale) was 88 (93.7%). Age and years from menopause-to-surgery were negatively (β = −0.16, P = 0.01) and positively (β = 0.14, P = 0.01) associated with the PGI-I scale. The aging effect was lost after adjusting for prolapse grade.

Conclusion

The greater the number of years from menopause-to-pelvic organ prolapse surgery, the less satisfied were the patients. The association between older patients and greater satisfaction appears to be a confounding effect of prolapse grade.
Literatur
1.
Zurück zum Zitat Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL (1997) Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 89:501–506CrossRefPubMed Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL (1997) Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 89:501–506CrossRefPubMed
2.
Zurück zum Zitat Mant J, Painter R, Vessey M (1997) Epidemiology of genital prolapse: observations from the Oxford Family Planning Association Study. Br J Obstet Gynaecol 104:579–585PubMed Mant J, Painter R, Vessey M (1997) Epidemiology of genital prolapse: observations from the Oxford Family Planning Association Study. Br J Obstet Gynaecol 104:579–585PubMed
3.
Zurück zum Zitat Ellerkmann RM, Cundiff GW, Melick CF, Nihira MA, Leffler K, Bent AE (2001) Correlation of symptoms with location and severity of pelvic organ prolapse. Am J Obstet Gynecol 185:1332–1337CrossRefPubMed Ellerkmann RM, Cundiff GW, Melick CF, Nihira MA, Leffler K, Bent AE (2001) Correlation of symptoms with location and severity of pelvic organ prolapse. Am J Obstet Gynecol 185:1332–1337CrossRefPubMed
4.
Zurück zum Zitat Elkadry EA, Kenton KS, FitzGerald MP, Shott S, Brubaker L (2003) Patient-selected goals: a new perspective on surgical outcome. Am J Obstet Gynecol 189:1551–1557CrossRefPubMed Elkadry EA, Kenton KS, FitzGerald MP, Shott S, Brubaker L (2003) Patient-selected goals: a new perspective on surgical outcome. Am J Obstet Gynecol 189:1551–1557CrossRefPubMed
5.
Zurück zum Zitat Pham T, Kenton K, Mueller E, Brubaker L (2009) New pelvic symptoms are common after reconstructive pelvic surgery. Am J Obstet Gynecol 200(88):e81–e85 Pham T, Kenton K, Mueller E, Brubaker L (2009) New pelvic symptoms are common after reconstructive pelvic surgery. Am J Obstet Gynecol 200(88):e81–e85
6.
Zurück zum Zitat Bradley CS, Nygaard IE (2005) Vaginal wall descensus and pelvic floor symptoms in older women. Obstet Gynecol 106:759–766PubMed Bradley CS, Nygaard IE (2005) Vaginal wall descensus and pelvic floor symptoms in older women. Obstet Gynecol 106:759–766PubMed
7.
Zurück zum Zitat Mokrzycki ML, Mittal K, Smilen SW, Blechman AN, Porges RF, Demopolous RI (1997) Estrogen and progesterone receptors in the uterosacral ligament. Obstet Gynecol 90:402–404CrossRefPubMed Mokrzycki ML, Mittal K, Smilen SW, Blechman AN, Porges RF, Demopolous RI (1997) Estrogen and progesterone receptors in the uterosacral ligament. Obstet Gynecol 90:402–404CrossRefPubMed
8.
Zurück zum Zitat Gurel H, Gurel SA (1999) Pelvic relaxation and associated risk factors: the results of logistic regression analysis. Acta Obstet Gynecol Scand 78:290–293CrossRefPubMed Gurel H, Gurel SA (1999) Pelvic relaxation and associated risk factors: the results of logistic regression analysis. Acta Obstet Gynecol Scand 78:290–293CrossRefPubMed
9.
Zurück zum Zitat Hextall A, Cardozo L (2001) The role of estrogen supplementation in lower urinary tract dysfunction. Int Urogynecol J Pelvic Floor Dysfunct 12:258–261CrossRefPubMed Hextall A, Cardozo L (2001) The role of estrogen supplementation in lower urinary tract dysfunction. Int Urogynecol J Pelvic Floor Dysfunct 12:258–261CrossRefPubMed
10.
Zurück zum Zitat Lang JH, Zhu L, Sun ZJ, Chen J (2003) Estrogen levels and estrogen receptors in patients with stress urinary incontinence and pelvic organ prolapse. Int J Gynaecol Obstet 80:35–39CrossRefPubMed Lang JH, Zhu L, Sun ZJ, Chen J (2003) Estrogen levels and estrogen receptors in patients with stress urinary incontinence and pelvic organ prolapse. Int J Gynaecol Obstet 80:35–39CrossRefPubMed
11.
Zurück zum Zitat Baden WF, Walker T (1992) Surgical repair of vaginal defects. Lippincott, Philadelphia Baden WF, Walker T (1992) Surgical repair of vaginal defects. Lippincott, Philadelphia
12.
Zurück zum Zitat Yalcin I, Bump RC (2003) Validation of two global impression questionnaires for incontinence. Am J Obstet Gynecol 189:98–101CrossRefPubMed Yalcin I, Bump RC (2003) Validation of two global impression questionnaires for incontinence. Am J Obstet Gynecol 189:98–101CrossRefPubMed
13.
Zurück zum Zitat Sowers MR, Zheng H, McConnell D, Nan B, Harlow SD, Randolph JF Jr (2008) Estradiol rates of change in relation to the final menstrual period in a population-based cohort of women. J Clin Endocrinol Metab 93:3847–3852CrossRefPubMed Sowers MR, Zheng H, McConnell D, Nan B, Harlow SD, Randolph JF Jr (2008) Estradiol rates of change in relation to the final menstrual period in a population-based cohort of women. J Clin Endocrinol Metab 93:3847–3852CrossRefPubMed
14.
Zurück zum Zitat Ewies AA, Al-Azzawi F, Thompson J (2003) Changes in extracellular matrix proteins in the cardinal ligaments of post-menopausal women with or without prolapse: a computerized immunohistomorphometric analysis. Hum Reprod 18:2189–2195CrossRefPubMed Ewies AA, Al-Azzawi F, Thompson J (2003) Changes in extracellular matrix proteins in the cardinal ligaments of post-menopausal women with or without prolapse: a computerized immunohistomorphometric analysis. Hum Reprod 18:2189–2195CrossRefPubMed
15.
Zurück zum Zitat Yamamoto K, Yamamoto M, Akazawa K, Tajima S, Wakimoto H, Aoyagi M (1997) Decrease in elastin gene expression and protein synthesis in fibroblasts derived from cardinal ligaments of patients with prolapsus uteri. Cell Biol Int 21:605–611CrossRefPubMed Yamamoto K, Yamamoto M, Akazawa K, Tajima S, Wakimoto H, Aoyagi M (1997) Decrease in elastin gene expression and protein synthesis in fibroblasts derived from cardinal ligaments of patients with prolapsus uteri. Cell Biol Int 21:605–611CrossRefPubMed
16.
Zurück zum Zitat Brincat M, Versi E, Moniz CF, Magos A, de Trafford J, Studd JW (1987) Skin collagen changes in postmenopausal women receiving different regimens of estrogen therapy. Obstet Gynecol 70:123–127PubMed Brincat M, Versi E, Moniz CF, Magos A, de Trafford J, Studd JW (1987) Skin collagen changes in postmenopausal women receiving different regimens of estrogen therapy. Obstet Gynecol 70:123–127PubMed
17.
Zurück zum Zitat Smith R, Studd J (1994) Estrogens and depression in women. In: Lobo R (ed) Treatment of the postmenopausal woman: basic and clinical aspects. Raven Press, New York, pp 129–136 Smith R, Studd J (1994) Estrogens and depression in women. In: Lobo R (ed) Treatment of the postmenopausal woman: basic and clinical aspects. Raven Press, New York, pp 129–136
18.
Zurück zum Zitat Klaiber EL, Broverman DM, Vogel W, Peterson LG, Snyder MB (1997) Relationships of serum estradiol levels, menopausal duration, and mood during hormonal replacement therapy. Psychoneuroendocrinology 22:549–558CrossRefPubMed Klaiber EL, Broverman DM, Vogel W, Peterson LG, Snyder MB (1997) Relationships of serum estradiol levels, menopausal duration, and mood during hormonal replacement therapy. Psychoneuroendocrinology 22:549–558CrossRefPubMed
19.
Zurück zum Zitat Liu YM, Choy KW, Lui WT, Pang MW, Wong YF, Yip SK (2006) 17beta-estradiol suppresses proliferation of fibroblasts derived from cardinal ligaments in patients with or without pelvic organ prolapse. Hum Reprod 21:303–308CrossRefPubMed Liu YM, Choy KW, Lui WT, Pang MW, Wong YF, Yip SK (2006) 17beta-estradiol suppresses proliferation of fibroblasts derived from cardinal ligaments in patients with or without pelvic organ prolapse. Hum Reprod 21:303–308CrossRefPubMed
20.
Zurück zum Zitat Hendrix SL, Cochrane BB, Nygaard IE, Handa VL, Barnabei VM, Iglesia C et al (2005) Effects of estrogen with and without progestin on urinary incontinence. JAMA 293:935–948CrossRefPubMed Hendrix SL, Cochrane BB, Nygaard IE, Handa VL, Barnabei VM, Iglesia C et al (2005) Effects of estrogen with and without progestin on urinary incontinence. JAMA 293:935–948CrossRefPubMed
21.
Zurück zum Zitat Verheul HA, Blok LJ, Burger CW, Hanifi-Moghaddam P, Kloosterboer HJ (2007) Levels of tibolone and estradiol and their nonsulfated and sulfated metabolites in serum, myometrium, and vagina of postmenopausal women following treatment for 21 days with tibolone, estradiol, or estradiol plus medroxyprogestrone acetate. Reprod Sci 14:160–168CrossRefPubMed Verheul HA, Blok LJ, Burger CW, Hanifi-Moghaddam P, Kloosterboer HJ (2007) Levels of tibolone and estradiol and their nonsulfated and sulfated metabolites in serum, myometrium, and vagina of postmenopausal women following treatment for 21 days with tibolone, estradiol, or estradiol plus medroxyprogestrone acetate. Reprod Sci 14:160–168CrossRefPubMed
22.
Zurück zum Zitat Suzme R, Yalcin O, Gurdol F, Gungor F, Bilir A (2007) Connective tissue alterations in women with pelvic organ prolapse and urinary incontinence. Acta Obstet Gynecol Scand 86:882–888CrossRefPubMed Suzme R, Yalcin O, Gurdol F, Gungor F, Bilir A (2007) Connective tissue alterations in women with pelvic organ prolapse and urinary incontinence. Acta Obstet Gynecol Scand 86:882–888CrossRefPubMed
23.
Zurück zum Zitat Jolleys JV (1988) Reported prevalence of urinary incontinence in women in a general practice. Br Med J (Clin Res Ed) 296:1300–1302CrossRef Jolleys JV (1988) Reported prevalence of urinary incontinence in women in a general practice. Br Med J (Clin Res Ed) 296:1300–1302CrossRef
24.
Zurück zum Zitat Van Geelen JM, Doesburg WH, Thomas CM, Martin CB Jr (1981) Urodynamic studies in the normal menstrual cycle: the relationship between hormonal changes during the menstrual cycle and the urethral pressure profile. Am J Obstet Gynecol 141:384–392PubMed Van Geelen JM, Doesburg WH, Thomas CM, Martin CB Jr (1981) Urodynamic studies in the normal menstrual cycle: the relationship between hormonal changes during the menstrual cycle and the urethral pressure profile. Am J Obstet Gynecol 141:384–392PubMed
25.
Zurück zum Zitat Moalli PA, Debes KM, Meyn LA, Howden NS, Abramowitch SD (2008) Hormones restore biomechanical properties of the vagina and supportive tissues after surgical menopause in young rats. Am J Obstet Gynecol 199(161):e161–e168 Moalli PA, Debes KM, Meyn LA, Howden NS, Abramowitch SD (2008) Hormones restore biomechanical properties of the vagina and supportive tissues after surgical menopause in young rats. Am J Obstet Gynecol 199(161):e161–e168
26.
Zurück zum Zitat Chung DJ, Bai SW (2006) Roles of sex steroid receptors and cell cycle regulation in pathogenesis of pelvic organ prolapse. Curr Opin Obstet Gynecol 18:551–554CrossRef Chung DJ, Bai SW (2006) Roles of sex steroid receptors and cell cycle regulation in pathogenesis of pelvic organ prolapse. Curr Opin Obstet Gynecol 18:551–554CrossRef
27.
Zurück zum Zitat Chen HY, Chung YW, Lin WY, Chen WC, Tsai FJ, Tsai CH (2008) Estrogen receptor alpha polymorphism is associated with pelvic organ prolapse risk. Int Urogynecol J Pelvic Floor Dysfunct 19:1159–1163CrossRefPubMed Chen HY, Chung YW, Lin WY, Chen WC, Tsai FJ, Tsai CH (2008) Estrogen receptor alpha polymorphism is associated with pelvic organ prolapse risk. Int Urogynecol J Pelvic Floor Dysfunct 19:1159–1163CrossRefPubMed
28.
Zurück zum Zitat Chen HY, Wan L, Chung YW, Chen WC, Tsai FJ, Tsai CH (2008) Estrogen receptor beta gene haplotype is associated with pelvic organ prolapse. Eur J Obstet Gynecol Reprod Biol 138:105–109CrossRefPubMed Chen HY, Wan L, Chung YW, Chen WC, Tsai FJ, Tsai CH (2008) Estrogen receptor beta gene haplotype is associated with pelvic organ prolapse. Eur J Obstet Gynecol Reprod Biol 138:105–109CrossRefPubMed
29.
Zurück zum Zitat Lowenstein L, FitzGerald MP, Kenton K, Dooley Y, Templehof M, Mueller ER et al (2008) Patient-selected goals: the fourth dimension in assessment of pelvic floor disorders. Int Urogynecol J Pelvic Floor Dysfunct 19:81–84PubMed Lowenstein L, FitzGerald MP, Kenton K, Dooley Y, Templehof M, Mueller ER et al (2008) Patient-selected goals: the fourth dimension in assessment of pelvic floor disorders. Int Urogynecol J Pelvic Floor Dysfunct 19:81–84PubMed
Metadaten
Titel
Years from menopause-to-surgery is a major factor in the post-operative subjective outcome for pelvic organ prolapse
verfasst von
Ki Hoon Ahn
Tak Kim
Jun Young Hur
Sun Haeng Kim
Kyu Wan Lee
Young Tae Kim
Publikationsdatum
01.08.2010
Verlag
Springer-Verlag
Erschienen in
International Urogynecology Journal / Ausgabe 8/2010
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-010-1133-1

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