Pelvic Organ Prolapse In Women Research Articles

Re: Association between Joint Hypermobility and Pelvic Organ Prolapse in Women: A Systematic Review and Meta-Analysis.

No AccessJournal of UrologyUrological Survey1 Nov 2017Re: Association between Joint Hypermobility and Pelvic Organ Prolapse in Women: A Systematic Review and Meta-Analysis Alan J. WeinMD, PhD (hon) Alan J. WeinAlan J. Wein More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.08.071AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "Re: Association between Joint Hypermobility and Pelvic Organ Prolapse in Women: A Systematic Review and Meta-Analysis." The Journal of Urology, 198(5), pp. 988–989 © 2017 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 198Issue 5November 2017Page: 988-989 Advertisement Copyright & Permissions© 2017 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alan J. Wein More articles by this author Expand All Advertisement PDF downloadLoading ...

Pelvic organ prolapse in women: what are the patient expectations of the prospective treatment?

Background. Personalized approach to the issue of pelvic organ prolapse in women assumes a detailed analysis of the patient’s expectations from the surgical treatment ahead.
 Aim: detailing the treatment goals for patients with POP.
 Materials and methods: Four hundred eighty six patients (mean age 54.3 ± 9.5 years) participated in a survey designed based on content from verbal reports of women with POP seeking medical help.
 Results: Out of 9 presented options patients indicated 2–7 treatment goals. The most frequently specified main goals of the treatment were: cure of urinary incontinence (48.6%), correction of vaginal wall prolapse (27.1%), and improvement of quality of sexual life (10.3%).
 Conclusion. Patients with POP indicate numerous objectives of surgical treatment. Treatment of urinary incontinence is the most frequently sought out main goal.

Birds of a feather?

The complications of using vaginal mesh for pelvic organ prolapse are well known. SCENIHR (Scientific Committee on Emerging and Newly Identified Health Risks), NHS England Mesh working Group and the Scottish Independent Review of the Use, Safety and Efficacy of Transvaginal Mesh Implants in the Treatment of Stress Urinary Incontinence and Pelvic Organ Prolapse in Women all published reports in 2016. Their conclusions have overlapping themes, with an emphasis on the need for robust clinical governance, multi-disciplinary team working, thorough audit, and recording and reporting of adverse events. Adequate patient information and informed consent is a fundamental principle underlying all healthcare management. The midurethral synthetic sling is made of the same type 1 macroporous material as vaginal prolapse mesh and so slings have been included with mesh in adverse publicity with a consequent decline in their use, with resurgence of fascial slings and more complex surgery such as colposuspension. The impact of this has been particularly evident in Scotland, where patients have been refusing to have a synthetic sling. As recently as 2011, it was common practice to inform patients that a synthetic sling was the procedure of choice and it was acceptable to give this as the sole option. This is now in violation of the Montgomery ruling of the UK Supreme Court (Montgomery v Lanarkshire Health Board [2015] UKSC 11), which requires a thorough discussion of pros and cons and alternatives. However, complete cessation of use, as has been the case with vaginal mesh, would equate to throwing the baby out with the bathwater. The price would be paid by the patient, who would end up with more complex surgery, with greater overall risks (apart from the risks of any synthetic material, i.e. extrusion and erosion, which are low in the case of sub-urethral slings). Some patients would likely be denied treatment altogether on the grounds of obesity or other comorbidities which make them unsuitable for an abdominal procedure. The midurethral sling is no longer a ‘new’ device and has reassuring 17-year follow-up data with a 90% objective continence rate and no serious long-term tape-induced adverse effects (Nilsson et al. Int Urogynecol J 2013;24:1265-9). So at what point is a prosthesis considered well established in clinical practice? In the history of implantable devices, defective/faulty ones will usually be identified within 10 years of market launch. Examples include trocar-guided meshes for prolapse, PIP breast implants, and Pinnacle Hip implants. On the other hand, the full extent of complications with synthetic slings such as extrusion and erosion may not yet be apparent. In the UK, we need to centralise the management of mesh-related complications in specialist units to allow the development of the expertise needed for successful remediation. With patient groups such as TVT MUM clamouring for a total ban on the product, there is an urgent need for the development of agreed clinical decision-making tools to enable patients to make fully informed choices in the management of their urinary incontinence. None declared. Completed disclosure of interests form available to view online as supporting information. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.

Female pelvic floor dysfunction from the perspectives of genetic studies

Currently, despite the growing prevalence of female pelvic floor dysfunction, no consensus exists among researchers regarding its etiology and pathogenesis. There is no doubt, however, that this is a multifactorial disorder with a genetic predisposition. The risk for developing pelvic floor dysfunction is determined by the interaction of multiple additive genetic (mutations and/or polymorphic alleles) and environmental factors. This review of the world literature presents a rationale for searching specific molecular genetic factors shaping the structure of the genetic susceptibility to female pelvic floor dysfunction. The pelvic organ prolapse in women has been found to be associated with the rs1800012 polymorphism of the COL1A1 gene, genotype rs1800255-A/A of COL3A1 gene and the rs2228480 polymorphism of ESR1, although this data still controversial and need to be validated in the independent samples. The systematic accumulation of data, their reproduction in different populations and ethnic groups is necessary to further generalize the evidence on the pathogenesis and the functional significance of each gene variant.

Practice Bulletin No. 176 Summary: Pelvic Organ Prolapse.

Pelvic organ prolapse (POP) is a common, benign condition in women. For many women it can cause vaginal bulge and pressure, voiding dysfunction, defecatory dysfunction, and sexual dysfunction, which may adversely affect quality of life. Women in the United States have a 13% lifetime risk of undergoing surgery for POP (1). Although POP can occur in younger women, the peak incidence of POP symptoms is in women aged 70-79 years (2). Given the aging population in the United States, it is anticipated that by 2050 the number of women experiencing POP will increase by approximately 50% (3). The purpose of this joint document of the American College of Obstetricians and Gynecologists and the American Urogynecologic Society is to review information on the current understanding of POP in women and to outline guidelines for diagnosis and management that are consistent with the best available scientific evidence.

Practice Bulletin No. 176: Pelvic Organ Prolapse.

Pelvic organ prolapse (POP) is a common, benign condition in women. For many women it can cause vaginal bulge and pressure, voiding dysfunction, defecatory dysfunction, and sexual dysfunction, which may adversely affect quality of life. Women in the United States have a 13% lifetime risk of undergoing surgery for POP (). Although POP can occur in younger women, the peak incidence of POP symptoms is in women aged 70-79 years (). Given the aging population in the United States, it is anticipated that by 2050 the number of women experiencing POP will increase by approximately 50% (). The purpose of this joint document of the American College of Obstetricians and Gynecologists and the American Urogynecologic Society is to review information on the current understanding of POP in women and to outline guidelines for diagnosis and management that are consistent with the best available scientific evidence.

The Association Between Levator-Urethra Gap Measurements and Symptoms and Signs of Female Pelvic Organ Prolapse.

Levator avulsion is associated with pelvic organ prolapse in women. It is diagnosed clinically by a widened gap on palpation between the insertion of the puborectalis muscle on the inferior pubic ramus and the urethra. This gap can also be assessed on imaging. This study aimed to determine the association between sonographically determined levator-urethral gap (LUG) measurements and symptoms and signs of prolapse. This is a retrospective study on 450 women seen in a tertiary urogynecological center for symptoms of pelvic floor dysfunction between January 2013 and February 2014. All had a standardized interview, International Continence Society Pelvic Organ Prolapse Quantification assessment and 4-dimensional translabial ultrasound. Post-imaging analysis of archived ultrasound volumes for LUG measurement was undertaken on tomographic slices at the plane of minimal hiatal dimensions and within 5-mm cranial to this plane, bilaterally at an interslice interval of 2.5 mm, blinded against all clinical data. A LUG of 25 mm or greater was considered abnormal. Mean LUG and maximum LUG in individuals were 22.5 mm (SD, 4.6) and 26.4 mm (SD, 6.0), respectively, with at least 1 abnormal LUG in 51% (n = 222). An abnormal LUG in all 3 slices involving the plane of minimal hiatal dimensions and within 5 mm cranial to this plane on at least 1 side was fulfilled in 24% (n = 103). The LUG measurements were strongly associated with bother, symptoms and signs of prolapse (P < 0.001 to 0.002). This remained significant on multivariate analysis controlling for potential confounding factors. Sonographically determined LUG is strongly associated with symptoms, symptom bother, and pelvic organ prolapse on clinical examination and imaging.

Prevalence of, and risk factors for, symptomatic pelvic organ prolapse in Rural Bangladesh: a cross-sectional survey study.

The prevalence of symptomatic pelvic organ prolapse (POP), diagnosed by a pre-tested structured questionnaire, is unknown in Bangladesh. We investigated the prevalence of, and risk factors for, symptomatic POP in women in rural Bangladesh, recruited from the community. A cross-sectional survey of 787 women aged over 15years was conducted in four villages in one district in rural Bangladesh. The prevalence of symptomatic POP and the risk factors associated with the condition was investigated, using Chi-squared and multivariate logistic regression. The prevalence of symptomatic POP was 15.6%. The mean age of participants was 40.1 (±9.0) years. Women aged 35-44 years (odds ratio [OR] 1.96, 95% confidence interval [CI] 1.03-3.73) and ≥45years (OR 2.95, 95 % CI 1.62-5.38) were more likely to have POP compared with women aged ≤35years. Having POP was positively associated with women having ≥5 children (OR 4.34, 95% CI 1.39-13.58), having chronic obstructive pulmonary disease (COPD; OR 2.07, 95% CI 1.02-4.21), and women having constipation (OR 3.54, 95% CI 1.87-6.72). Women whose husband had >5years of schooling were less likely to have POP (OR 0.37, 95% CI 0.19-0.73) compared with women whose husband had no schooling. Symptomatic POP affects a substantial proportion of women in rural Bangladesh and increases with age. Parity, COPD, constipation and husband's education are associated with POP, all of which have the potential to be modified. Thus, interventions targeting these risk factors to prevent the condition are urgently needed in Bangladesh.

Comments to: surgical management of pelvic organ prolapse in women.

Comments to: surgical management of pelvic organ prolapse in women.

13: Genetic determinants of pelvic organ prolapse in women of european american descent: The women’s health initiative

CONCLUSION: Instrument utilization in the Gynecologic operating room is low but comparable to other surgical specialties, and the cost of processing instruments is significant. Availability of certain instruments is necessary for patient safety in the event of rare unexpected events. However, given that significantly less than half of the instruments pulled for surgery are utilized and that total processing cost per instrument exceeds three dollars, careful review of what instruments are included in each tray and elimination of wasted resource allocation can result in significant cost savings without reducing safety.

Changes in mitochondrial DNA copy number and extracellular matrix (ECM) proteins in the uterosacral ligaments of premenopausal women with pelvic organ prolapse

ObjectiveThe study aimed to explore the changes in mitochondrial DNA (mtDNA) copy number, collagen, and matrix metalloproteinase (MMPs) expression with pelvic organ prolapse (POP) in the uterosacral ligaments of premenopausal women. Materials and methodsA group of 56 premenopausal women, all younger than 52 years of age, were enrolled in this study. Uterosacral ligament (UL) biopsies were obtained from uterine specimens taken from 22 women with POP (n = 22, study group) and 34 myoma patients without POP (n = 34, control group) during abdominal or vaginal hysterectomy. Quantitative real-time polymerase chain reaction (Q-PCR) and immunohistochemistry analysis were applied in the present study. ResultsThe rate of high body mass index (BMI) (> 24 kg/m2) women was significantly higher in the POP group (81.8% vs. 35.3%, p = 0.001 *), and the BMI of the POP women was higher than that of the nonPOP women (p = 0.029 *). The mtDNA copy number (p = 0.001 *), collagen III alpha 1 (COL3α1) expression (p = 0.025 *), and MMP2 expression (p = 0.047 *) were significantly higher in the POP group when compared with the nonPOP group. The high BMI women had a higher mtDNA copy number (p = 0.002 *), COL3α1 (p = 0.028 *) gene expressions compared with the standard BMI women. ConclusionIn the premenopausal state, higher BMI may be a stronger associate factor than vaginal birth for the development of POP. The higher mtDNA copy number, COL3α1, and MMP2 gene expressions are highly associated with POP in the UL of premenopausal women.

Association between joint hypermobility and pelvic organ prolapse in women: a systematic review and meta-analysis.

Abnormalities of common collagen proteins have been noted in individuals affected by POP and JHM, suggesting a common aetiology. We assessed strength, consistency and potential for bias in pooled associations of the relationship between JHM and POP. We searched MEDLINE, EMBASE and CINAHL, as well as International Continence Society (ICS) and International Urogynaecologic Association (IUGA) annual meeting abstracts, including reference lists, without language restrictions. We included case-control and cohort studies and applied strict criteria for choosing eligible studies. Methodologically trained reviewers independently screened abstracts and full texts to confirm eligibility. We extracted data on study and patient characteristics, clinical assessment tools, and methodology. We assessed comparability and representativeness of source populations, confidence in the assessment of JHM and POP and adjustment for confounding and missing data. Meta-analysis was performed using a random effects model. We retrieved 39 full texts, of which 14 were used in the meta-analysis. Overall pooled odds ratio (OR) was 2.37 [95% confidence interval (CI) 1.54-3.64, I(2) = 77.0%]. We identified no significant factors in meta-regression, and there was no evidence of publication bias; six studies were at high risk of bias with frequent differences in sampling frames, limited validity for clinical assessments and failure to match for important prognostic variables. We found a strong association between POP and JHM, with an effect size that is clinically relevant. Our findings are limited by high heterogeneity and the potential for residual confounding factors. JHM is an important early indicator for POP risk, and future longitudinal studies should explore the shared aetiology.

Characteristics associated with pelvic organ prolapse in women with significant levator ani muscle deficiency.

Age is a factor associated with symptomatic pelvic organ prolapse (POP) among women with significant levator ani deficiency. This cross-sectional study included patients who were referred for varied pelvic floor disorders, had 3D endovaginal ultrasound as part of their evaluation, and were diagnosed with significant levator ani muscle deficiency defined as a score of 12 or more on 3D endovaginal ultrasound. Patients were categorized as having no pelvic organ prolapse (stages 0 and 1), or symptomatic prolapse (stages 2-4). Seventy-six women were available for analysis and found to have significant levator ani muscle deficiency, including 51 with symptomatic POP and 25 without POP. Patients with symptomatic POP were older, (mean age 66 (SD ± 11.8) vs 48 (SD ± 17.3) years; p <0.0001), had greater mean minimal levator hiatus (MLH) area (19.7 cm(2) (SD ± 4.6) vs 17.5 cm(2) (SD ± 3.5); p = 0.048), and were more likely to be menopausal (91.3 % vs 54.5 %; p <0.001) compared with those with no POP. In a modified Poisson regression analysis excluding nulliparous women, increasing age (RR = 2.39, 95 % CI 1.03-5.55) and smoking (RR = 1.34, 95 % CI 1.08-1.67) remained associated with symptomatic POP after controlling for one another and the MLH area. Among women with significant levator ani deficiency, older women and smokers had an increased prevalence of symptomatic POP. On average, women without POP, but with significant levator ani deficiency were 18 years younger than women with POP and significant muscle deficiency.

Efficacy and outcomes of transobturator tension-free vaginal tape with or without concomitant pelvic floor repair surgery for urinary stress incontinence: five-year follow-up.

To compare the 5-year subjective and objective outcomes of transobturator tension-free vaginal tape alone versus the same procedure with concomitant pelvic floor repair surgery for pelvic organ prolapse in women with urinary stress incontinence. Prospective cohort study. Urogynaecology unit at a university hospital in Hong Kong. Of 218 women, 96 (44%) received transobturator tension-free vaginal tape alone and 122 (56%) received transobturator tension-free vaginal tape with concomitant pelvic floor repair surgery from September 2004 to December 2009. The women were followed up annually for up to 5 years after the operation. The 5-year subjective and objective cure rates were assessed. Subjective cure was defined as no urine loss during physical activity and objective cure was defined as no urine leakage on coughing during urodynamic study. Overall, 88 women receiving transobturator tension-free vaginal tape alone and 101 women receiving transobturator tension-free vaginal tape with concomitant pelvic floor repair surgery were followed up for 5 years after operation. The subjective and objective cure rates of the two groups were 70.5% versus 94.1% (P<0.01) and 80.3% versus 85.7% (P=0.58), respectively. Transobturator tension-free vaginal tape is an effective treatment for urinary stress incontinence in women who received it alone or with concomitant pelvic floor repair surgery for pelvic organ prolapse, providing high subjective and objective efficacy for up to 5 years after operation. Transobturator tension-free vaginal tape with concomitant pelvic floor repair surgery achieved similar, if not better, long-term outcome compared with transobturator tension-free vaginal tape alone.

Pelvic-Floor-Muscle Training Adherence: Tools, Measurements and Strategies-2011 ICS State-of-the-Science Seminar Research Paper II of IV.

This paper on pelvic-floor-muscle training (PFMT) adherence, the second of four from the International Continence Society's 2011 State-of-the-Science Conference, aims to (1) identify and collate current adherence outcome measures, (2) report the determinants of adherence, (3) report on PFMT adherence strategies, and (4) make actionable clinical and research recommendations. Data were amassed from a literature review and an expert panel (2011 conference), following consensus statement methodology. Experts in pelvic floor dysfunction collated and synthesized the evidence and expert opinions on PFMT adherence for urinary incontinence (UI) and lower bowel dysfunction in men and women and pelvic organ prolapse in women. The literature was scarce for most of the studied populations except for limited research on women with UI. Exercise diaries were the most widely-used adherence outcome measure, PFMT adherence was inconsistently monitored and inadequately reported. Determinants: Research, mostly secondary analyses of RCTs, suggested that intention to adhere, self-efficacy expectations, attitudes towards the exercises, perceived benefits and a high social pressure to engage in PFMT impacted adherence. Few trials studied and compared adherence strategies. A structured PFMT programme, an enthusiastic physiotherapist, audio prompts, use of established theories of behavior change, and user-consultations seem to increase adherence. The literature on adherence outcome measures, determinants and strategies remains scarce for the studied populations with PFM dysfunction, except in women with UI. Although some current adherence findings can be applied to clinical practice, more effective and standardized research is urgently needed across all the sub-populations.

CHANGES IN THE QUALITY OF LIFE AND SEXUAL FUNCTION IN WOMEN WITH PELVIC PROLAPSE AFTER LIGATION OF COLPOPEXY WITH POLYPROPYLENE MESH

Objective. To evaluate the effect of vaginal operations to eliminate pelvic prolapse using polypropylene implants on quality of life and sexual function of patients. Materials and methods. The study included 93 women with genital prolapse II - IV stage, underwent extraperitoneal colpopexy polypropylene implant. The patients were divided into two groups according to the method of vaginal ligation of colpopexy: in group 1 (n = 50) included patients who underwent the surgery perforated polypropylene implant Cineplex (LINTEX, Russia) according to the developed method (patent RF № 2538796); 2 (n = 43) group included patients who had an operation using standard kits with polypropylene mesh (ProliftTM, Prolift™ + M, ProsimaTM ETHICON Women's Health & Urology Johnson & Johnson Company, USA). The quality of social and sexual life was assessed using the questionnaire to calculate the index of sexual function in women (Female Sexual Function Index (FSFI)) and non-specific questionnaire of quality of life SF-36 preoperatively and 6 months after. Results . In patients prior to surgical intervention compared with the general population indicators of quality of life statistically significantly reduced for all scales. Physical health component (PHC) reduced by 57.8% in the 1st group and 59.5 per cent in the 2nd group, and psychological health (PsCH) by 42% and 43.5% respectively groups compared with the general population indicators. In the postoperative period, significant improvement in the quality of life in the 2 treatment groups compared with preoperative observed in all parameters. In group 1 noted that PHC restored by 32%, and PsCH 40.7%; in the 2nd group - PHC improved by 26.1% and PsCH of 29.4% (Fig. 2). Comparative analysis of the quality of life of patients after surgery compared groups showed that in group 1 was able to significantly (p<0.05) improve social functioning and mental health patients in comparison with group 2. The total score of the index of sexual function after surgery was significantly increased in the 1st group from 15.8 ± 5.3 to 25.2 ± 4,2; in the 2nd group - from 15.5 ± 5 to 21.4 ± 6. Intergroup statistical analysis of the index of female sexual function after surgical treatment of pelvic prolapse showed significant improvement (p<0.05) in the 1st group for all indicators (desire, arousal, lubrication, orgasm, satisfaction and total score), in addition to the indicator dyspareunia, in comparison with patients of the 2nd group. Conclusions . The pelvic organ prolapse in women significantly affects their quality of life and becomes the cause of sexual disorders. Vaginal reconstruction of pelvic prolapse using polypropylene implants in sexually active women leads to better sexual function by eliminating the loss of the walls of the vagina and urinary incontinence. However, the peculiarities of surgical intervention are responsible for the reduced orgasmic function and appearance of dyspareunia. In patients after vaginal ligation of colpopexy using perforated polypropylene implant according to the developed method was significantly improved sexual function in all indicators of the FSFI questionnaire in comparison with the patients operated using a standard set with polypropylene implant for the correction of pelvic prolapse.

Pelvic organ prolapse in women: how is it diagnosed and treated currently?

The aim of the paper was to summarize the current opinions about the management of pelvic organ prolapse in women. Food and Drug Administration safety announcements from 2008 and 2011 triggered the discussion about the methods of treatment of pelvic organ prolapse and the used materials and a partial return to the methods which had been totally criticized before the implementation of meshes. The decrease in mesh usage is also observed. The studies did not demonstrate the prevalence of any particular surgical procedure. The amount of studies concerning the evaluation and the treatment of pelvic organ prolapse ensures that the quality of care provided to women with urogynecological problems is continuously increasing.

Increased incidence of pelvic organ prolapse in women with acromegaly

ObjectiveTo evaluate gynecological problems of female patients with acromegaly and the relationship of these problems with the activity of the disease. Study designThirty-four women with acromegaly and 27 age- and body mass index-matched female healthy controls (HC) were included in the study. Demographic features, medical history, hormonal status and disease activity were obtained. A detailed gynecological examination was performed. ResultsThe incidence of pelvic organ prolapse (POP) was higher in patients with acromegaly (53%, n=18) compared to the HC (15%, n=4) (p=0.003). Limiting the analysis to only cases with previous pregnancy, POP was seen in 18 (60%) of 30 cases with acromegaly and in 4 (20%) of 20 of the HC (p=0.005). Additionally, in cases with prior vaginal delivery, POP was present in 18 (60%) of 30 cases with acromegaly and in 4 (24%) of 17 of the HC (p=0.02). The frequency of POP was similar in patients with controlled and uncontrolled acromegaly (p=0.3). ConclusionAcromegaly may facilitate occurrence of pelvic organ prolapse and may cause additional health issues in female cases.

Surgical treatment for pelvic organ prolapse in elderly women

The objective was to analyse the feasibility, safety and outcome of surgical treatment for pelvic organ prolapse in women ≥ 65 years of age. A single-centre retrospective, cohort study was performed through a medical records review and telephone interview. Women ≥ 65 years of age, who underwent a surgical operation for pelvic organ prolapse, were considered. Overall, 305 women were included. The following procedures (alone or in combination) were performed: 168 (52.1%) vaginal hysterectomy; 264 (81.9%) anterior colporrhaphy; 261 (81.0%) posterior colpoperineorrhaphy and 45 (13.8%) Manchester operation. There were two cases of bladder injury (0.6%) and two cases of vaginal haematoma (0.6%). Urinary retention and febrile morbidity were found in 33 (10.8%) and 35 (11.5%) of women, respectively. Clinical follow-up, median 10 months, showed that 178 of 200 (89.0%) women had anatomical success. Traditional reconstructive surgical operation for pelvic organ prolapse is a viable treatment option in elderly women.

Lifetime risk of stress urinary incontinence or pelvic organ prolapse surgery.

To estimate the lifetime risk of stress urinary incontinence (SUI) surgery, pelvic organ prolapse (POP) surgery, or both using current, population-based surgical rates from 2007 to 2011. We used a 2007-2011 U.S. claims and encounters database. We included women aged 18-89 years and estimated age-specific incidence rates and cumulative incidence (lifetime risk) of SUI surgery, POP surgery, and either incontinence or prolapse surgery with 95% confidence intervals (CIs). We estimated lifetime risk until the age of 80 years to be consistent with prior studies. From 2007 to 2011, we evaluated 10,177,480 adult women who were followed for 24,979,447 person-years. Among these women, we identified 65,397 incident, or first, SUI and 57,755 incident prolapse surgeries. Overall, we found that the lifetime risk of any primary surgery for SUI or POP was 20.0% (95% CI 19.9-20.2) by the age of 80 years. Separately, the cumulative risk for SUI surgery was 13.6% (95% CI 13.5-13.7) and that for POP surgery was 12.6% (95% CI 12.4-2.7). For age-specific annual risk, SUI demonstrated a bimodal peak at age 46 years and then again at age 70-71 years with annual risks of 3.8 and 3.9 per 1,000 women, respectively. For POP, the risk increased progressively until ages 71 and 73 years when the annual risk was 4.3 per 1,000 women. Based on a U.S. claims and encounters database, the estimated lifetime risk of surgery for either SUI or POP in women is 20.0% by the age of 80 years. III.