Risk factors for the recurrence of pelvic organ prolapse

To investigate the risk factors for the recurrence of prolapse after traditional pelvic reconstructive surgery.

The medical records of 212 patients who received traditional restorative reconstructive surgeries for symptomatic pelvic organ prolapse from March 1999 to April 2006 were retrospectively analyzed. Recurrence was defined as any prolapse of stage II or greater according to the Pelvic Organ Prolapse Quantification system. The log-rank test and Cox regression of the Kaplan-Meier survival analysis were used in univariate analysis, and the Cox proportional hazard model was used in multivariate analysis.

The median follow-up period was 24 (range 1-84) months and the number of patients suffering from recurrence was 36 (17.0%). Age, parity, repetitive heavy lifting/chronic constipation, family history, hormone replacement therapy status, and preoperative stage all had an influence on the outcome, although preoperative stage IV was the only independent risk factor (hazard ratio (HR) 5.6, 95% CI 1.1-29.3, p = 0.044). Analyzing by compartments, preoperative stage IV (HR 18.6, 95% CI 2.1-162.3, p = 0.018) was an independent risk factor for the recurrence in anterior compartment, not for posterior or apical.

Patients with a far advanced preoperative stage (stage IV), especially in cases of anterior prolapse, are more likely to experience a recurrence after traditional reconstructive surgery.