MP05-18 DO PREOPERATIVE DEMOGRAPHICS OR SYMPTOMS PREDICT RECURRENCE IN PATIENTS FOLLOWING COMBINED SURGICAL REPAIR FOR PELVIC ORGAN PROLAPSE AND RECTAL PROLAPSE?

Abstract

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Pelvic Prolapse (MP05)1 Apr 2020MP05-18 DO PREOPERATIVE DEMOGRAPHICS OR SYMPTOMS PREDICT RECURRENCE IN PATIENTS FOLLOWING COMBINED SURGICAL REPAIR FOR PELVIC ORGAN PROLAPSE AND RECTAL PROLAPSE? Raveen Syan, Shannon Wallace*, Brooke Gurland, and Ekene Enemchukwu Raveen SyanRaveen Syan More articles by this author , Shannon Wallace*Shannon Wallace* More articles by this author , Brooke GurlandBrooke Gurland More articles by this author , and Ekene EnemchukwuEkene Enemchukwu More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000819.018AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Growing evidence suggests combined surgical repair for pelvic organ prolapse (POP) and rectal prolapse (RP) is safe and effective, however recurrence rates of POP and/or RP following combined surgery are poorly described. We sought to characterize demographics and presenting symptoms in patients undergoing combined repair and determine pre-operative predictors of recurrence. METHODS: We performed a retrospective review of women who underwent combined RP and POP surgery at a single tertiary center from 2008-2019. Patient demographic data and preoperative symptoms were collected. Patients with recurrent POP (Stage 2 anatomic prolapse) and/or RP on examination were identified. RESULTS: Sixty-three women with a mean follow up time of 1.1 years were evaluated. Five patients were lost to follow up. Mean age at the time of surgery was 65, and the majority patients were Caucasian (62%) and non-smokers (51%) (Figure 1A). The most commonly reported symptoms related to POP were overactive bladder (OAB) (73%) and vaginal bulge (79%), while the most commonly reported symptoms related to RP were obstructive defecation (51%) and fecal incontinence (FI) (68%) (Figure 1A). Postoperatively, 71% of patients with OAB and 87% of patients with vaginal bulge symptoms reported improvement in symptom. Similarly, 81% of patients with obstructive defecation and 79% of patients with FI reported improvement in symptoms. Of thirteen patients (22%) with recurrent POP and/or RP, 7 patients had recurrent POP and 10 had recurrent RP. Increasing age, pulmonary disease, obesity, obstructive urination and obstructive defecation were associated with recurrent POP and/or RP (Figure 1B). After adjusting for confounders, age (OR 1.10 [1.03-1.22]), obesity (OR 25.97 [2.56-623.14]), and obstructive defecation (OR 6.57 [1.03-69.57]) remained statistically significant (Figure 1B). CONCLUSIONS: Though majority of patients who undergo combined POP and RP surgery have improvement in symptoms related to RP and POP, our study suggests that older, obese, women with pre-operative obstructive defecation may have a higher risk of prolapse recurrence. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e48-e49 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Raveen Syan More articles by this author Shannon Wallace* More articles by this author Brooke Gurland More articles by this author Ekene Enemchukwu More articles by this author Expand All Advertisement PDF downloadLoading ...