1. Long-term outcomes and predictors of failure after surgery for stage IV apical pelvic organ prolapse
- Author
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Christopher J. Klingele, Amy L. Weaver, Deborah J. Rhodes, Brian J. Linder, Emanuel C. Trabuco, Michaela E. McGree, Sherif A. El-Nashar, Alain A. Mukwege, John B. Gebhart, and John A. Occhino
- Subjects
Adult ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,Uterosacral ligament ,Kaplan-Meier Estimate ,Hysterectomy ,Severity of Illness Index ,Pelvic Organ Prolapse ,Young Adult ,03 medical and health sciences ,Gynecologic Surgical Procedures ,Postoperative Complications ,0302 clinical medicine ,Interquartile range ,Statistical significance ,Humans ,Medicine ,Treatment Failure ,030212 general & internal medicine ,Proportional Hazards Models ,030219 obstetrics & reproductive medicine ,business.industry ,Proportional hazards model ,Medical record ,Hazard ratio ,Age Factors ,Obstetrics and Gynecology ,Confidence interval ,Surgery ,Treatment Outcome ,medicine.anatomical_structure ,Vagina ,Female ,business - Abstract
The aim of this study was to compare outcomes after uterosacral ligament suspension (USLS) or sacrocolpopexy for symptomatic stage IV apical pelvic organ prolapse (POP) and evaluate predictors of prolapse recurrence. The medical records of patients managed surgically for stage IV apical POP from January 2002 to June 2012 were reviewed. A follow-up survey was sent to these patients. The primary outcome, prolapse recurrence, was defined as recurrence of prolapse symptoms measured by validated questionnaire or surgical retreatment. Survival time free of prolapse recurrence was estimated using the Kaplan–Meier method, and Cox proportional hazards models evaluated factors for an association with recurrence. Of 2633 women treated for POP, 399 (15.2%) had stage IV apical prolapse and were managed with either USLS (n = 355) or sacrocolpopexy (n = 44). Those managed with USLS were significantly older (p
- Published
- 2017