Abstract
Introduction and hypothesisPelvic organ prolapse (POP) recurrence after surgery is a major problem. POP that is more advanced preoperatively is associated with a higher risk of recurrence postoperatively. We hypothesized that women with a stage 2 cystocele differ from those with a stage 3 or 4 cystocele. The aim of this study was to compare the baseline characteristics of women with mild and those with more advanced cystocele.MethodsPatients had participated in one of two multicenter prospective cohort studies on women undergoing conventional anterior colporrhaphy without previous POP surgery. This was a secondary analysis of these data. Women with a preoperative cystocele stage 2 were compared with women with a stage 3 or 4 cystocele. Logistic regression models were employed to calculate odds ratios (OR) and 95% confidence intervals (CI).ResultsTwo hundred and sixty-nine women were assessed, of whom 132 (49.1%) had an advanced cystocele. Only older age was significantly associated with advanced cystocele preoperatively, with an OR of 1.07 (95% CI 1.04–1.10). There were no significant differences between women with advanced or stage 2 cystocele in body mass index, vaginal deliveries, assisted delivery, positive family history of POP, concurrent rectocele, concurrent uterine of vaginal vault prolapse, major levator ani muscle defects, or levator hiatal area.ConclusionsWomen with advanced cystocele were significantly older than women with stage 2 cystocele. This raises the question whether it would be favorable to perform POP surgery in an earlier stage, i.e., at a younger age, in order to prevent POP recurrence.
Highlights
Introduction and hypothesisPelvic organ prolapse (POP) recurrence after surgery is a major problem
The aim of that study was to determine whether levator defects were a risk factor for cystocele recurrence and to identify other risk factors associated with recurrence [12]
Age was significantly associated with advanced cystocele
Summary
Pelvic organ prolapse (POP) recurrence after surgery is a major problem. POP that is more advanced preoperatively is associated with a higher risk of recurrence postoperatively. Female pelvic organ prolapse (POP) is a common condition that can have a great negative impact on women’s social, physical, and psychological well-being [1]. Women may have symptoms such as feeling or seeing a bulge in their vagina, or they may have micturition, defecation, and sexual problems. POP recurrence after surgery is a major problem, with anatomical recurrence rates reported in the literature from 31% up to 59% [6, 7]. Anterior-compartment prolapse, referred to as cystocele, is the most commonly affected in POP and is the most prone for recurrence after surgery [8, 9]
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