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Prolapse phenotypes and 12-month postoperative prolapse recurrence after apical native tissue surgery: a combined
Katherine Weston1, Kimberly A Kenne2, Catherine S Bradley2
1Carver College of Medicine, University of Iowa, Iowa City, IA.
American Journal of Obstetrics and Gynecology
|April 12, 2026
Summary
Pelvic organ prolapse phenotypes did not predict recurrence after native tissue repair surgery. Further research is needed to understand outcomes in less common prolapse subgroups.
Area of Science:
- Urogynecology
- Pelvic Floor Disorders
- Surgical Outcomes
Background:
- Pelvic organ prolapse (POP) recurrence after surgery is common.
- Recurrence rates vary based on baseline prolapse characteristics.
- Understanding POP phenotypes may personalize surgical treatment and improve outcomes.
Purpose of the Study:
- To determine the association between POP phenotypes and symptomatic recurrence 12 months after vaginal native-tissue apical prolapse surgery.
- To investigate associations between phenotypes and anatomic recurrence or new-onset stress urinary incontinence (SUI).
Main Methods:
- Secondary analysis of data from three randomized trials and one patient registry.
- Categorization of 704 participants into 8 POP phenotypes using the POP-Q system.
- Primary outcome: symptomatic recurrence defined by the Pelvic Floor Distress Inventory 'bulge' question.
Main Results:
- The anterior-predominant and apical prolapse phenotype was most common (67.2%).
- Overall symptomatic recurrence was 9.2%, with rates varying by phenotype (0-29%).
- Phenotype was not significantly associated with symptomatic or anatomic recurrence, or new/worsening SUI.
Conclusions:
- POP-Q phenotypes were not associated with symptomatic recurrence after native tissue repair.
- Most women undergoing this surgery present with anterior-predominant and apical prolapse.
- Larger studies may be necessary to detect differences in outcomes for less common phenotypes.
