AIMS: Female pelvic organ prolapse is a common condition.
Prolapse recurrence following surgical treatment is a significant clinical issue. The aim of this study was to determine risk factors for recurrence, attempting to improve clinical practice by allowing better patient selection prior to surgery.
METHODS: This was a retrospective study utilising patient records and ultrasound volume imaging data sets obtained in four clinical audits following anterior colporrhaphy ± mesh. Prolapse recurrence was diagnosed clinically and by ultrasound; findings were analysed against potential predictors.
RESULTS: Symptomatic prolapse recurrence was demonstrated in 86 (26%), on clinical examination in 141 (42%) and on ultrasound in 113/334 women (34%). None of the tested predictors were predictive of recurrent symptoms, likely due to a lack of power. However, both levator avulsion and hiatal area on Valsalva were shown to be highly significant predictors of objective prolapse recurrence on clinical examination and ultrasound.
CONCLUSIONS: Prolapse recurrence following surgery is a common complaint. The state of the patient's pelvic floor muscle seems to be the strongest determinant.
Written by:
Rodrigo N, Wong V, Shek KL, Martin A, Dietz HP. Are you the author?
Sydney Medical School Nepean, Penrith, New South Wales, Australia.
Reference: Aust N Z J Obstet Gynaecol. 2014 Feb 18. Epub ahead of print.
doi: 10.1111/ajo.12171
PubMed Abstract
PMID: 24576013
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