Trends in apical prolapse surgery between 2010 and 2016 in Denmark

Area of Science:

• Urogynecology
• Surgical Innovation
• Pelvic Floor Disorders

Background:

• Pelvic organ prolapse (POP) is a common condition affecting many women.
• Current surgical management for apical prolapse lacks a definitive consensus on the optimal technique.
• While vaginal hysterectomy with vaginal cuff suspension is common, uterus-preserving methods are gaining traction.

Purpose of the Study:

• To analyze trends in surgical techniques for primary apical prolapse in Danish hospitals between 2010 and 2016.
• To investigate the influence of hospital specialization level on the adoption of different surgical approaches.

Main Methods:

• Retrospective analysis of data from the Danish Urogynecological Database (2010-2016).
• Inclusion of women undergoing primary surgery for apical prolapse.
• Categorization of public hospitals based on urogynecological specialization: high, moderate, and no specialization.

Main Results:

• A decrease in vaginal hysterectomies and a corresponding increase in uterus-preserving operations were observed from 2010 to 2016.
• Adoption of uterus-preserving techniques varied significantly by hospital specialization.
• Highly specialized departments showed a substantial increase in uterus-preserving procedures, reaching nearly 90% by 2016, compared to less specialized departments.

Conclusions:

• The use of uterus-preserving techniques for apical prolapse has increased over time in Denmark.
• Significant variations in surgical practice exist across different hospital types and specialization levels.
• A unified approach or consensus on uterus-preserving techniques for apical prolapse has not yet been established.