The development of pelvic organ prolapse after colposuspension: a prospective, long-term follow-up study on the prevalence and predisposing factors

Abstract

The objectives of this prospective study were to determine the prevalence of pelvic organ prolapse (POP) after colposuspension and to investigate possible preoperative and operative risk factors. Seventy-seven women who underwent colposuspension between 1996 and 1997 were investigated. POP was assessed before colposuspension using the pelvic organ prolapse quantification system (POPQ). Women were reassessed at one and seven to eight years (or when referred with symptomatic POP). By seven to eight years, of the 77 women, 29 (38%) had developed symptomatic prolapse, 29 (38%) had asymptomatic prolapse, 7 (9%) had no symptoms and no prolapse, and 12 (15%) could not be assessed. POP at one year was significantly associated with the presence of posterior vaginal descent before colposuspension (odds ratio 3.07, 95% CI 1.10-8.60, p = 0.03). No variable reached statistical significance by eight years postcolposuspension. In conclusion, this is the first study to assess POP prospectively using a validated method before and after colposuspension. The results add support to the view that there is an association between colposuspension and the development of symptomatic POP (requiring surgery).

What do we do when a midurethral tape fails? Rediscovery of open colposuspension as a salvage continence operation

“…However, repeat urodynamic studies postoperatively revealed a significant decrease in the maximum flow rate, which may reflect an element of outflow obstruction, although there was not significant change in the postvoid residuals and maximum detrusor pressure. The prevalence of symptomatic prolapse following colposuspension in our study is within the reported range in the literature [26]. Different theories have been proposed to explain the possible association between colposuspension and POP.…”

Obesity and Pelvic Floor Disorders

“…After 8 years of follow-up, 38% had developed symptomatic prolapse and another 38% had asymptomatic prolapse. Again, BMI was not found to have a significant association with surgical failure (54). …”

Tension‐free vaginal tape versus colposuspension for primary urodynamic stress incontinence: 5‐year follow up

“…Previously reported long‐term case series have reported an increase in symptomatic prolapse, as well as a substantial requirement for prolapse surgery following colposuspension which may be as high as 32% 19 . Our data support these findings with a high incidence of posterior vaginal wall and vault prolapse following colposuspension.…”