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SUFU 2018: Concomitant Hysterectomy Lowers the Rate Of Recurrent Prolapse Surgery for all Compartments in a Cohort of Over 100,000 Women

Austin, TX (UroToday.com)  Dr. Kai B. Dallas and colleagues presented a retrospective study of 108,561 women who underwent an anterior, apical, and/or posterior repair for pelvic organ prolapse in all non-federal hospitals in the state of California, from 2005-2011, via data from the Office of Statewide Health Planning and Development.  The objective of the study was to examine the effect of concomitant hysterectomy at the time of prolapse repair in regard to prolapse recurrence.  Women who had undergone a hysterectomy prior to prolapse repair were excluded from analysis.  Average follow up time was 3.6 years.

45.1% of women in the cohort underwent concomitant hysterectomy at the time of prolapse repair.  The authors found that the rates for repeat surgery for recurrent prolapse were lower among all types of prolapse (anterior, apical, and posterior compartments), if hysterectomy was performed at the time of index repair, 1.3%.  Multivariate modeling was preformed, adjusting for several variables, including age, race, insurance, comorbidities, mesh use and concurrent incontinence procedure.  This demonstrated that hysterectomy was protective against recurrence for anterior (OR=0.69), apical (OR=0.75), and posterior (OR=0.63) prolapse (p<0.01).

The authors’ findings that concomitant hysterectomy undergoing POP repair decreases the risk of recurrent POP surgery. This finding was in contrast to a recent meta analysis performed of 5,392 patients, and with a shorter time of follow up.

Presented by: Kai B. Dallas, MD, Stanford, CA

Co-Authors: Ekene Enemchukwu MD, Raveen Syan MD, Ericka Sohlberg MD¹, Christopher Elliott MD and Lisa Rogo-Gupta MD, Stanford Urology

Written by: Cristina Palmer, DO. Female Urology, Pelvic Reconstruction, Voiding Dysfunction Fellow, Department of Urology, UC Irvine Medical Center, Orange, California at the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction Winter Meeting (SUFU 2018), February 27-March 3, 2018, Austin, Texas