Predictors for Pelvic Organ Prolapse Recurrence After Sacrocolpopexy: A Matched Case-Control Study
| Autor: | Emily R W Davidson, Cecile A. Ferrando, Marie Fidela R. Paraiso, Tonya N Thomas, Olivia H. Chang |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Sacrum Urology 030232 urology & nephrology Logistic regression Pelvic Organ Prolapse Odds 03 medical and health sciences 0302 clinical medicine Gynecologic Surgical Procedures Recurrence medicine Secondary Prevention Humans Sex organ Aged Retrospective Studies Pelvic organ 030219 obstetrics & reproductive medicine business.industry Incidence (epidemiology) Case-control study Obstetrics and Gynecology Odds ratio Middle Aged Confidence interval Surgery Cross-Sectional Studies Case-Control Studies Vagina Female business Follow-Up Studies |
| Zdroj: | Female pelvic medicinereconstructive surgery. 27(1) |
| ISSN: | 2154-4212 |
| Popis: | Objective This study aimed to identify risk factors for prolapse recurrence after sacrocolpopexy. Methods This was a retrospective chart review with cross-sectional follow-up survey of 709 patients who underwent sacrocolpopexy of any modality from 2004 to 2014. Cases were defined as those with a composite failure, defined as having subjective bulge symptoms, retreatment, or anatomic prolapse (≥stage 2 prolapse on the Pelvic Organ Prolapse Quantification system). Controls were patients without composite failure. The cases and controls were matched by surgeon and by date of surgery in a 1:4 ratio. Results We identified 153 cases and matched them to 487 controls. The overall incidence of prolapse recurrence was 21.6% (95% confidence interval [CI], 18.2%-24.1%). Of the recurrence cases, 34 (22.2%) underwent surgical retreatment; the most common surgical retreatment was a posterior colporrhaphy (n = 16 [47.1%]). On multivariable logistic regression, a preoperative genital hiatus size ≥4 cm (adjusted odds ratio [adjOR], 1.95; 95% CI, 1.18-3.25) and concurrent anterior colporrhaphy (adjOR, 2.11; 95% CI, 1.06-4.18) were associated with increased odds of having a composite failure. Patients who had a concurrent posterior colporrhaphy had lower odds of experiencing a failure (adjOR, 0.62; 95% CI, 0.42-0.94). Conclusions In this large retrospective chart review of women who underwent sacrocolpopexy with a cross-sectional survey follow-up time frame of nearly 7 years, patients with a preoperative genital hiatus of 4 cm or greater and need for concurrent anterior colporrhaphy at the time of their index surgery had higher odds of prolapse recurrence. Conversely, women who underwent a concurrent posterior colporrhaphy had lower odds of a recurrence. |
| Databáze: | OpenAIRE |
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