Most older women recover baseline functional status following pelvic organ prolapse surgery.

Abstract

To evaluate postoperative functional status changes in older women undergoing pelvic organ prolapse (POP) surgery and determine predictors for nonrecovery of baseline status. We enrolled women ≥ 65 years in whom POP surgery was planned and measured functional status using the Katz Activities of Daily Living (ADL) and Lawton Instrumental Activities of Daily Living (IADL) scales at baseline, 1 week, 2 weeks, and 3 months postoperatively. We used logistic regression modeling to identify predictors of postoperative nonrecovery of functional status (score < baseline) and calculated score change over time. Sixty-six women were enrolled and 3-month data were complete for 53. Subjects had a mean age of 72 ± 5 years, were all Caucasian, and had predominantly undergone vaginal surgery (70 %). At baseline 31% were ADL-dependent and 12% were IADL-dependent. Both ADL and IADL scores changed significantly over time (p <0.001). At 3 months postoperatively, 19% of women failed to return to baseline ADLs and 25% failed to return to baseline IADLs. At all time points ADL dependence was almost entirely attributable to lack of continence, while IADL dependence was commonly due to the inability to independently perform activities outside the home. Age, number of comorbidities, depression, and baseline functional status were not significant predictors of IADL nonrecovery. In a model controlling for baseline IADL status, age, and BMI, higher baseline Colorectal-Anal Distress Inventory (CRADI) score significantly predicted IADL nonrecovery (AOR 1.13, 95% CI 1.00,1.27, p = 0.04). Most older women with baseline functional status independence undergoing POP surgery can expect to regain independence by 3 months postoperatively.