Pelvic Organ Prolapse in Nulliparous Women and Their Parous Sisters

Buchsbaum, Gunhilde M.; Duecy, Erin E.; Kerr, Lindsey A.; Huang, Li‐Shan; Perevich, MaryAnn; Guzick, David S.

doi:10.1097/01.aog.0000245784.31082.ed

Cited by 75 publications

(37 citation statements)

References 20 publications

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“…It is nowadays widely accepted that underlying connective abnormalities, as well as hereditary factors, predispose to POP, and our study shows that they also predispose to POP recurrence [20][21][22][23].…”

Section: Discussionsupporting

confidence: 57%

Incidence and risk factors for reoperation of surgically treated pelvic organ prolapse

et al. 2011

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Introduction and hypothesis The objective of our study was to estimate the incidence and to identify the risk factors for reoperation of surgically treated pelvic organ prolapse (POP). Methods We conducted a nested case-control study among 1,811 women who underwent POP surgery from January 1988 to June 2007. Cases (n=102) were women who required reoperation for POP following the first intervention through December 2008. Controls (n=226) were women randomly selected from the same cohort who did not require reoperation. Results The incidence of POP reoperation was 5.1 per 1,000 women-years. The cumulative incidence was 5.6%. Risk factors included preoperative prolapse in more than two vaginal compartments (adjusted OR 5.2; 95% CI 2.8-9.7), history of surgery for POP and/or urinary incontinence (adjusted OR 3.2; 95% CI 1.5-7.1), and sexual activity (adjusted OR 2.0; 95% CI 1.0-3.7). Conclusions The risk of POP reoperation is relatively low and is associated with preexisting weakness of pelvic tissues.

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Section: Discussionsupporting

confidence: 57%

Incidence and risk factors for reoperation of surgically treated pelvic organ prolapse

et al. 2011

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“…However, also nulliparous women without any risk factors may develop POP. Therefore, a genetic predisposition may play a role as well [6][7][8]. When a mother has POP, the relative risk for the daughter of developing POP is 3.2.…”

Section: Introductionmentioning

confidence: 99%

Changes in connective tissue in patients with pelvic organ prolapse—a review of the current literature

2008

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Little is known about the pathophysiology of pelvic organ prolapse (POP). In 1996, Jackson presented a hypothesis on pelvic floor connective tissue that tried to explain the development of POP on a molecular level. The objective of this review is to test the hypothesis against recent literature. The method used was a review of literature. The association between POP and connective tissue metabolism is well established. However, the causality of this association is unclear. The characteristics of the pelvic floor connective tissue of POP patients relate to tissue repair. To resolve the question of cause and effect, the role of fibroblasts in producing the extracellular matrix should be clarified. With these data, the use of autologous or allogenic stem cells in the treatment of POP may come in sight. Recent literature supports the hypothesis of Jackson but does not resolve long-standing questions on the aetiology of POP.

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“…It is nowadays widely accepted that underlying connective abnormalities, (in addition to hereditary factors), predispose to POP, and our study shows that they also predispose to POP recurrence [20][21][22][23]. Nevertheless, we found that POP severity, expressed most distal preoperative POP stage, was associated with a significantly greater blood loss, and higher incidence rates of perioperative and long-term complications.…”

Section: Discussionmentioning

confidence: 44%

Comparison of perioperative, long-term complications and recurrence rates after vaginal prolapse surgery by considering ICS POP-Q stage

Jung

Kim

Moon

et al. 2012

Korean J Obstet Gynecol

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Pelvic organ prolapse (POP) is a bulge or protrusion into or through the vagina of pelvic organs and associated vaginal segments [1]. With the aging population, POP is an increasingly common condition seen in women with a lifetime prevalence of 30% to 50% [1,2]. Symptomatic urogenital prolapse has been shown to have significant negative impacts such as those relating to the lower urinary tract, fecal incontinence, back pain, pelvic pain, defecatory problems, and dyspareunia. Management options for women with symptomatic POP include observation, pelvic floor muscle training, mechanical support (pessaries), and surgery. A patient's perception of discomfort from POP and subsequent treatment will vary in relation to the stage of the POP and her ethnicity. Currently, many surgical approaches have been introduced to correct POP. The life time risk of undergoing surgery was estimated to be between 11% and 19%. However, none of these techniques is without risks for complications [2][3][4]. The prevalence of reopera-ORIGINAL ARTICLE Korean J Obstet Gynecol 2012;55(8) ObjectiveThe aim of this study was to report subjective and objective outcomes and to compare complication and recurrence rate in patients undergoing surgery for International Continence Society (ICS) stage 4 prolapse compared to ICS stage 2 or 3 prolapse. MethodsWe retrospectively reviewed the records of all patients having had surgical treatment for ICS Pelvic Organ Prolapse Quantification (POP-Q) stage 2-4 prolapse between January 2007 and December 2010 at the Yonsei University Severance Hospital. Only patients with ICS POP-Q stage 2-4 prolpase undergoing obliterative procedures or anti-incontinence surgery only were excluded. ResultsThree hundred ninety nine patients met inclusion criteria, including 23 with stage 2, 239 with stage 3 and 137 with stage 4 prolapse. The postoperative recurrence rate of preoperative stage IV was 2.4 times higher than that of stage III. There was a significantly higher incidence rates of perioperative and long-term complications, compared to women with other stage prolapse. The mean operative time was significantly greater in the stage 4 group compared to the stage 2, 3 group. ConclusionThe overall perioperative complication and recurrence rates in women undergoing surgery for pelvic organ prolapse are low. Women undergoing surgery for ICS POP-Q stage 4 prolapse were found to have a significantly greater blood loss and higher incidence rates of perioperative complications and recurrence, compared with women of other stage.

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Pelvic Organ Prolapse in Nulliparous Women and Their Parous Sisters

Abstract: II-2.

Cited by 75 publications

References 20 publications

Incidence and risk factors for reoperation of surgically treated pelvic organ prolapse

Incidence and risk factors for reoperation of surgically treated pelvic organ prolapse

Changes in connective tissue in patients with pelvic organ prolapse—a review of the current literature

Comparison of perioperative, long-term complications and recurrence rates after vaginal prolapse surgery by considering ICS POP-Q stage

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