Recurrent surgery in uterine prolapse: A nationwide register study
Abstract Introduction One in three women with pelvic organ prolapse (POP) undergoing surgery have a relapse. Currently, no optimal surgical treatment has been identified for correcting a uterine prolapse. This population‐based register study aims to compare the relapse rate in patients with uterine...
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| Format: | Article |
| Language: | English |
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Wiley
2022-05-01
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| Series: | Acta Obstetricia et Gynecologica Scandinavica |
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| Online Access: | https://doi.org/10.1111/aogs.14340 |
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| author | Malin Brunes Ulrika Johannesson Anna Drca Ida Bergman Marie Söderberg Anna Warnqvist Marion Ek |
| author_facet | Malin Brunes Ulrika Johannesson Anna Drca Ida Bergman Marie Söderberg Anna Warnqvist Marion Ek |
| author_sort | Malin Brunes |
| collection | DOAJ |
| description | Abstract Introduction One in three women with pelvic organ prolapse (POP) undergoing surgery have a relapse. Currently, no optimal surgical treatment has been identified for correcting a uterine prolapse. This population‐based register study aims to compare the relapse rate in patients with uterine prolapse undergoing hysterectomy with suspension or uterine‐sparing surgical procedures. Material and methods All women with uterine prolapse undergoing prolapse surgery in Sweden from January 1, 2015 to December 31, 2018, were identified from the Gynecological Operation Register (GynOp). The primary outcome was the number of recurrent POP surgeries up to December 31, 2020. Results Sacrospinous hysteropexy (SSHP) without graft and sacrohysteropexy (SHP) were associated with a significantly higher rate of recurrent POP surgery (SSHP without graft: adjusted odds ratio [aOR] 2.6, 95% CI 2.0–3.5; SHP aOR 2.6, 95% CI 1.8–3.7) and patients describing a sense of globe (SSHP without graft, aOR 2.0, 95% CI 1.6–2.6; SHP, aOR 1.8, 95% CI 1.1–3.1) compared with cervical amputation with uterosacral ligament fixation (Manchester procedure). There was no difference in the reoperation rate or sense of a globe between SSHP with graft and Manchester procedure. Patients undergoing SSHP without graft had a higher frequency of 1‐year postoperative complications compared with Manchester procedure (aOR 2.0, 95% CI 1.6–2.6) and SHP (aOR 2.4, 95% CI 1.4–3.9). Moreover, the frequency of 1‐year postoperative complications was higher in SSHP with graft (aOR 1.6, 95% CI 1.1–2.2) than in Manchester procedure. Conclusions The Manchester procedure was associated with a low rate of recurrent POP surgery, symptomatic recurrence and low surgical morbidity compared with other surgical methods in women with uterine prolapse. |
| format | Article |
| id | doaj-art-2bfbb98ce1994f469d51a33f1a6e2acb |
| institution | Kabale University |
| issn | 0001-6349 1600-0412 |
| language | English |
| publishDate | 2022-05-01 |
| publisher | Wiley |
| record_format | Article |
| series | Acta Obstetricia et Gynecologica Scandinavica |
| spelling | doaj-art-2bfbb98ce1994f469d51a33f1a6e2acb2025-08-20T03:30:57ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122022-05-01101553254110.1111/aogs.14340Recurrent surgery in uterine prolapse: A nationwide register studyMalin Brunes0Ulrika Johannesson1Anna Drca2Ida Bergman3Marie Söderberg4Anna Warnqvist5Marion Ek6Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet Stockholm SwedenDepartment of Clinical Sciences Danderyd Hospital, Karolinska Institutet Stockholm SwedenDepartment of Clinical Science and Education Södersjukhuset, Karolinska Institutet Stockholm SwedenDepartment of Clinical Science and Education Södersjukhuset, Karolinska Institutet Stockholm SwedenDepartment of Clinical Science and Education Södersjukhuset, Karolinska Institutet Stockholm SwedenInstitute for Environmental Medicine, Karolinska Institutet Stockholm SwedenDepartment of Clinical Science and Education Södersjukhuset, Karolinska Institutet Stockholm SwedenAbstract Introduction One in three women with pelvic organ prolapse (POP) undergoing surgery have a relapse. Currently, no optimal surgical treatment has been identified for correcting a uterine prolapse. This population‐based register study aims to compare the relapse rate in patients with uterine prolapse undergoing hysterectomy with suspension or uterine‐sparing surgical procedures. Material and methods All women with uterine prolapse undergoing prolapse surgery in Sweden from January 1, 2015 to December 31, 2018, were identified from the Gynecological Operation Register (GynOp). The primary outcome was the number of recurrent POP surgeries up to December 31, 2020. Results Sacrospinous hysteropexy (SSHP) without graft and sacrohysteropexy (SHP) were associated with a significantly higher rate of recurrent POP surgery (SSHP without graft: adjusted odds ratio [aOR] 2.6, 95% CI 2.0–3.5; SHP aOR 2.6, 95% CI 1.8–3.7) and patients describing a sense of globe (SSHP without graft, aOR 2.0, 95% CI 1.6–2.6; SHP, aOR 1.8, 95% CI 1.1–3.1) compared with cervical amputation with uterosacral ligament fixation (Manchester procedure). There was no difference in the reoperation rate or sense of a globe between SSHP with graft and Manchester procedure. Patients undergoing SSHP without graft had a higher frequency of 1‐year postoperative complications compared with Manchester procedure (aOR 2.0, 95% CI 1.6–2.6) and SHP (aOR 2.4, 95% CI 1.4–3.9). Moreover, the frequency of 1‐year postoperative complications was higher in SSHP with graft (aOR 1.6, 95% CI 1.1–2.2) than in Manchester procedure. Conclusions The Manchester procedure was associated with a low rate of recurrent POP surgery, symptomatic recurrence and low surgical morbidity compared with other surgical methods in women with uterine prolapse.https://doi.org/10.1111/aogs.14340apical prolapsepelvic organ prolapsereoperationuterine prolapse |
| spellingShingle | Malin Brunes Ulrika Johannesson Anna Drca Ida Bergman Marie Söderberg Anna Warnqvist Marion Ek Recurrent surgery in uterine prolapse: A nationwide register study Acta Obstetricia et Gynecologica Scandinavica apical prolapse pelvic organ prolapse reoperation uterine prolapse |
| title | Recurrent surgery in uterine prolapse: A nationwide register study |
| title_full | Recurrent surgery in uterine prolapse: A nationwide register study |
| title_fullStr | Recurrent surgery in uterine prolapse: A nationwide register study |
| title_full_unstemmed | Recurrent surgery in uterine prolapse: A nationwide register study |
| title_short | Recurrent surgery in uterine prolapse: A nationwide register study |
| title_sort | recurrent surgery in uterine prolapse a nationwide register study |
| topic | apical prolapse pelvic organ prolapse reoperation uterine prolapse |
| url | https://doi.org/10.1111/aogs.14340 |
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