Risk factors in the failure of surgical repair of pelvic organ prolapse |
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| Authors: | Díez-Calzadilla N A March-Villalba J A Ferrandis C Hernández J A Martínez-Jabaloyas J M Chuan P Martínez-García R |
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| Affiliation: | 1. Service de gynécologie obstétrique et médecine de la reproduction, hôpital Antoine-Béclère, AP–HP, 157, rue de la Porte-de-Trivaux, 92140 Clamart, France;2. Service de chirurgie gynécologie, hôpital La Pitié-Salpêtrière, AP–HP, 83, boulevard de l’Hôpital, 75013 Paris, France;3. Academic department of urology, université Paris 6, Pitié-Salpêtrière hospital, Assistance publique–Hôpitaux de Paris, 83, boulevard de l’Hôpital, 75013 Paris, France;1. Department of Urology, Mayo Clinic, Rochester, Minnesota;2. Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota;3. Surgical Outcomes Program, Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota;4. Division of Urology, Rhode Island Hospital and The Miriam Hospital, Providence, Rhode Island;5. Warren Alpert Medical School of Brown University, Providence, Rhode Island;1. Service de gynécologie-obstétrique urogynécologie, CHU Caremeau, place Robert-Debré, 30029 Nîmes cedex 9, France;2. Service d’urologie, hôpital de Bichat, AP–HP, 75018 Paris, France;3. Service d’urologie, hôpital Foch, AP–HP, 92150 Suresnes, France;4. Service d’urologie, CHU Caremeau, 30029 Nîmes cedex 9, France;5. Service de gynécologie-obstétrique, CHU Estaing, 63000 Clermont-Ferrand, France;1. Division of Urology, Department of Surgery, Ottawa Hospital, Ottawa, Ontario, Canada;2. Ottawa Hospital Research Institute, Ottawa Hospital, Ottawa, Ontario, Canada;3. Department of Urology, Langone Medical Center, New York University, New York, New York;1. Unidad de Urodinamia, Servicio de Urología, Hospital Clínico Universidad de Chile, Santiago, Chile;2. Unidad de Piso Pélvico Femenino, Servicio de Ginecología y Obstetricia, Hospital Clínico Universidad de Chile, Santiago, Chile |
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| Abstract: | IntroductionPelvic organ prolapse (POP) surgery has variable results of recurrence and complications. We have aimed to analyze our outcomes in order to know the factors associated with anatomical and functional failure in POP surgery.Material and methodsA retrospective study of 69 patients who underwent POP surgery at our hospital was performed. Registered variables were: Age, BMI, number of deliveries, previous pelvic surgery, menopause, quality of life, urinary incontinence, associated frequency-urgency symptoms, high POP stage, vaginal compartments repaired, type of mesh, urethro-suspension and vaginal hysterectomy during POP surgery and its complications. Patients were evaluated at 1, 6 and 12 months post-surgery. The technique was considered as failed when relapse or mesh erosion occurred and when the patient is not satisfied or there was relapse. The sample is described, analyzing the relationship of the variables studied by univariate analysis (Chi square and Mann-Whitney U test) and a study was made of which variables may have predictive value in the failure of the repair (multiple logistic regression).ResultsSurgery failed in 17 patients during the follow-up at one year. BMI (29.6 ± 2.03 vs 27.1 ± 3.32), delivery number (3.4 ± 0.71 vs. 2.8 ± 1.88), menopause, frequency- urgency symptoms and number of vaginal compartments repaired were associated with treatment failure although only BMI, delivery number and frequency-urgency symptoms were defined as independent predictive variables when the logistic regression was carried out.ConclusionsOverweightness-obesity, previous delivery number and frequency-urgency symptoms before surgery are factors associated to anatomical and functional failure after POP repair. |
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