Effect of prior hysterectomy on the anterior and posterior vaginal compartments of women presenting with pelvic organ prolapse

Shalom, Dara F.; Lin, Stephanie N.; O'Shaughnessy, D.; Lind, L.F.; Winkler, Harvey A.

doi:10.1016/j.ijgo.2012.06.014

Intl J Gynecology & Obste

2012

DOI: 10.1016/j.ijgo.2012.06.014

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Effect of prior hysterectomy on the anterior and posterior vaginal compartments of women presenting with pelvic organ prolapse

Dara F. Shalom

Stephanie N. Lin

D. O'Shaughnessy

et al.

Abstract: When matched for age and parity, women with prior hysterectomy had significantly greater posterior compartment prolapse compared with those without. Prior hysterectomy had no significant effect on the anterior vaginal compartment.

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Cited by 4 publications

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“…Considering yearly surgical costs in the US have been consistently greater than one billion USD since 1997, it is safe to project that the surgical healthcare expense for pelvic organ prolapse (POP) will be exponentially increased by 2050 [2]. Hysterectomy, among other factors, has been associated with an increased risk for subsequent POP [3][4][5][6][7]. Altman et al studied the risk for POP surgery attributed to hysterectomy until the year 2003 [4].…”

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confidence: 99%

Pelvic organ prolapse surgery after different hysterectomy methods: a population-based cohort study

Klimczak

Kilic

Ünlü

et al. 2019

Clin. Exp. Obstet. Gynecol.

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The US Census Bureau projects that the number of American women with at least one pelvic floor disorder will increase from 28.1 million in 2010 to 43.8 million in 2050 [1]. Considering yearly surgical costs in the US have been consistently greater than one billion USD since 1997, it is safe to project that the surgical healthcare expense for pelvic organ prolapse (POP) will be exponentially increased by 2050 [2]. Hysterectomy, among other factors, has been associated with an increased risk for subsequent POP [3][4][5][6][7]. Altman et al. studied the risk for POP surgery attributed to hysterectomy until the year 2003 [4]. However, since 2003, rapidly developing technology has created a shift towards laparoscopic and robotic techniques for uterine removal as opposed to the open laparotomy method [8, 9].Although the benefits of laparoscopic/robotic modalities are well known, their association with future risk for prolapse, compared to vaginal or open abdominal hysterectomy, remains unclear. The present authors utilized a large-scale patient population to examine the association of future prolapse repair with different types of hysterectomy.The aim of this study was to estimate the incidence of POP surgery after abdominal hysterectomies compared to laparoscopic/robotic-assisted, vaginal, and supracervical hysterectomies for benign cases in the US. Materials and MethodsThe present authors conducted a retrospective cohort study using health insurance claims from the Clinformatics Data Mart (CDM) Database. This de-identified database contains insurance claims for medical services and drug prescriptions for over 56 million enrollees in the US. This study was determined to be exempt by the institutional review board of the University of Texas Medical Branch at Galveston.The study cohort consisted of women aged 18-64 who received hysterectomies between January 2005 and September 2014 (Table 1) with any of the following modalities: robotic or laparoscopic, supracervical, open abdominal, or vaginal procedures (Table 2). The authors included women who had continuous insurance enrollment 12 months before and three months after the hysterectomies (Figure 1). The authors excluded women with prolapse procedure or diagnosis (Table 3) in the 12 months prior to hysterectomy because they are more likely to have a prolapse compared to those without history regardless of the hysterectomy modality. The authors also excluded any concomitant prolapse procedures or diagnoses, as well as prolapse procedures or diagnoses in the immediate three months following hysterectomy (Figure 1). That is, the authors excluded POP that was not identified

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mentioning

confidence: 99%

Pelvic organ prolapse surgery after different hysterectomy methods: a population-based cohort study

Klimczak

Kilic

Ünlü

et al. 2019

Clin. Exp. Obstet. Gynecol.

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Incidence of pelvic organ prolapse repair subsequent to hysterectomy: a comparison between radical hysterectomy and total abdominal hysterectomy

et al. 2016

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Hysterectomy technique and risk of pelvic organ prolapse repair: a Danish nationwide cohort study

Lykke

Løwenstein

Blaakær

et al. 2017

Arch Gynecol Obstet

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Effect of prior hysterectomy on the anterior and posterior vaginal compartments of women presenting with pelvic organ prolapse

Abstract: When matched for age and parity, women with prior hysterectomy had significantly greater posterior compartment prolapse compared with those without. Prior hysterectomy had no significant effect on the anterior vaginal compartment.

Cited by 4 publications

References 16 publications

Pelvic organ prolapse surgery after different hysterectomy methods: a population-based cohort study

Pelvic organ prolapse surgery after different hysterectomy methods: a population-based cohort study

Incidence of pelvic organ prolapse repair subsequent to hysterectomy: a comparison between radical hysterectomy and total abdominal hysterectomy

Hysterectomy technique and risk of pelvic organ prolapse repair: a Danish nationwide cohort study

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