Lifetime risk of surgical management for pelvic organ prolapse or urinary incontinence

Fialkow, Michael; Newton, Katherine M.; Lentz, Gretchen M.; Weiss, Noel S.

doi:10.1007/s00192-007-0459-9

Cited by 201 publications

(107 citation statements)

References 10 publications

(9 reference statements)

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“…Morphological changes in the levator hiatus may have clinical signifi cance in the subsequent development of urinary incontinence and pelvic organ prolapsed [16,21]. The levator ani muscle is thought to play a signifi cant role in the pathogenesis of these highly prevalent conditions and it is estimated that parous women have an increased lifetime risk (by age 80) of undergoing surgical treatment for one of these conditions [22]. Pregnancy and childbirth are frequently cited as major etiological factors, and various obstetric parameters (e.g., length of second-stage labor, birth weight, and mode of delivery) have been demonstrated to be additional risk factors [23,24].…”

Section: Discussionmentioning

confidence: 99%

Characteristics of the pelvic floor during pregnancy by 2D and 3D ultrasound

Hong

Cho

Kang

et al. 2011

Korean J Obstet Gynecol

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Section: Discussionmentioning

confidence: 99%

Characteristics of the pelvic floor during pregnancy by 2D and 3D ultrasound

Hong

Cho

Kang

et al. 2011

Korean J Obstet Gynecol

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“…A second survey was conducted 5 years later [2] and demonstrated a consistent rise in the use of vaginal mesh with little change in the use of other surgical procedures for pelvic organ prolapse (POP). The risk of recurrent prolapse and the need for further surgery were responsible for the increase in mesh usage [3][4][5]. Following US Food and Drug Administration (FDA) approval for vaginal mesh for POP in 2002, there was a significant increase in mesh procedures for both primary and recurrent prolapse, and recurrence rates were quoted as the reason for this increase.…”

Section: Introductionmentioning

confidence: 99%

The UK national prolapse survey: 5 years on

Jha

Moran

2011

Int Urogynecol J

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Introduction and hypothesis To assess trends in the surgical management of pelvic organ prolapse (POP) amongst UK practitioners and changes in practice since a previous similar survey. Methods An online questionnaire survey (Typeform Pro) was emailed to British Society of Urogynaecology (BSUG) members. They included urogynaecologists working in tertiary centres, gynaecologists with a designated special interest in urogynaecology and general gynaecologists. The questionnaire included case scenarios encompassing contentious issues in the surgical management of POP and was a revised version of the questionnaire used in the previous surveys. The revised questionnaire included additional questions relating to the use of vaginal mesh and laparoscopic urogynaecology procedures. Results Of 516 BSUG members emailed, 212 provided completed responses.. For anterior vaginal wall prolapse the procedure of choice was anterior colporrhaphy (92% of respondents). For uterovaginal prolapse the procedure of choice was still vaginal hysterectomy and repair (75%). For posterior vaginal wall prolapse the procedure of choice was posterior colporrhaphy with midline fascial plication (97%). For vault prolapse the procedure of choice was sacrocolpopexy (54%) followed by vaginal wall repair and sacrospinous fixation (41%). The laparoscopic route was preferred for sacrocolpopexy (62% versus 38% for the open procedure). For primary prolapse, vaginal mesh was used by only 1% of respondents in the anterior compartment and by 3% in the posterior compartment. Conclusion Basic trends in the use of native tissue prolapse surgery remain unchanged. There has been a significant decrease in the use of vaginal mesh for both primary and recurrent prolapse, with increasing use of laparoscopic procedures for prolapse.

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“…The real incidence of POP is, consequently, unknown but is estimated to vary between 38% and 41% of the female population [2,3]. The lifetime risk for undergoing an operation for prolapse or urinary incontinence by age of 80 years is 11.1-11.8% [4,5].…”

Section: Introductionmentioning

confidence: 99%

Trocar-guided polypropylene mesh for pelvic organ prolapse surgery—perioperative morbidity and short-term outcome of the first 100 patients

et al. 2010

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This study was conducted to assess the subjective outcome, complications and cure rates of prolapse surgery with a standardized trocar-quided polypropylene mesh in the first 100 patients. A follow-up visit was made after 2 months after the operation and the subjective outcome was assessed with a postal questionnaire 1 year postoperatively. An anterior mesh was used in 48, posterior mesh in 45, total mesh in five and combined anterior and posterior mesh in two patients. All patients had one or more subjective symptoms. Forty-seven percent of the patients had undergone prolapse surgery and 16% an antiincontinence operation previously. Two patients had peroperative bleeding of more than 1,000 ml, antibiotic treatment was needed in 28 patients and two hematomas were evacuated. A total of 16 patients underwent an antiincontinence operation for de novo stress urinary incontinence. Four patients needed cystocele repair after a posterior mesh and eight patients posterior repair after an anterior mesh. The mesh exposure was diagnosed in 14 patients. No serious complications occurred. Fifty-three (60%) patients reported all preoperative symptoms cured, 27 (30%) reported persistent symptoms and five patients were hesitant. Of the respondents, 63 (71%) were satisfied with the operation. We found that the mesh procedures were associated with a quite high amount of minor postoperative problems.

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Lifetime risk of surgical management for pelvic organ prolapse or urinary incontinence

Cited by 201 publications

References 10 publications

Characteristics of the pelvic floor during pregnancy by 2D and 3D ultrasound

Characteristics of the pelvic floor during pregnancy by 2D and 3D ultrasound

The UK national prolapse survey: 5 years on

Trocar-guided polypropylene mesh for pelvic organ prolapse surgery—perioperative morbidity and short-term outcome of the first 100 patients

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