IMR Press / CEOG / Volume 46 / Issue 3 / DOI: 10.12891/ceog4683.2019

Clinical and Experimental Obstetrics & Gynecology (CEOG) is published by IMR Press from Volume 47 Issue 1 (2020). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.

Open Access Original Research
Pelvic organ prolapse surgery after different hysterectomy methods: a population-based cohort study
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1 Department of Obstetrics & Gynecology, Department of Preventive Medicine and Community Health, The University of Texas Medical Branch at Galveston, Galveston, TX, USA
2 Office of Biostatistics, Department of Preventive Medicine and Community Health, The University of Texas Medical Branch at Galveston, Galveston, TX, USA
3 Department of Obstetrics and Gynecology, Johns Hopkins Medicine, Baltimore, MD, USA
*Correspondence: amklimcz@utmb.edu (A. KLIMCZAK)
Clin. Exp. Obstet. Gynecol. 2019, 46(3), 466–472; https://doi.org/10.12891/ceog4683.2019
Published: 10 June 2019
Abstract

Background: Pelvic floor disorders are expected to greatly increase in the coming years. Many factors have been implicated in the development of pelvic organ prolapse (POP). In the last decade, the route of hysterectomy performed has shifted more towards robotic/laparoscopic techniques, and the role that the hysterectomy route plays in the need for future POP repair remains uncertain. Here the authors investigate the association of POP repair following robotic/laparoscopic hysterectomies, as well as vaginal, supracervical, and abdominal modalities. Results: Patients living in the West were more likely to have a prolapse repair post-hysterectomy than those living in the Midwest (HR 1.39; 95% CI: 1.01-1.93). Patients with hospital stays ≥ 4 days following hysterectomies were more likely to require future prolapse repairs than those with ≤ 1-day stays (HR 1.71; 95% CI: 1.10-2.65). Compared to abdominal procedures, robotic/laparoscopic modalities were more likely to be associated with prolapse within 18 months of hysterectomies (HR 1.72, 95% CI: 1.13-2.61). However, between 18 and 36 months, both supracervical and vaginal hysterectomies were more likely to be associated with prolapse surgeries (HR 1.96, 95% CI: 1.15-3.34 and HR 1.94; 95% CI: 1.02-3.70, respectively). Conclusions: Region and length of hospital stay significantly impacted the need for future prolapse repair. Among modalities, the association with prolapse repair changes with time.

Keywords
Pelvic organ prolapse
Hysterectomy
Prolapse repair
Figures
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