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Factors influencing the outcome of surgery for pelvic organ prolapse
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynecology.
Umeå University, Faculty of Science and Technology, Department of Mathematics and Mathematical Statistics.
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2018 (English)In: International Urogynecology Journal, ISSN 0937-3462, E-ISSN 1433-3023, Vol. 29, no 1, p. 81-89Article in journal (Refereed) Published
Abstract [en]

Pelvic organ prolapse (POP) surgery is a common gynecological procedure. Our aim was to assess the influence of obesity and other risk factors on the outcome of anterior and posterior colporrhaphy with and without mesh. Data were retrieved from the Swedish National Register for Gynecological Surgery on 18,554 women undergoing primary and repeat POP surgery without concomitant urinary incontinence (UI) surgery between 2006 and 2015. Multivariate logistic regression analyses were used to identify independent risk factors for a sensation of a vaginal bulge, de novo UI, and residual UI 1 year after surgery. The overall subjective cure rate 1 year after surgery was 80% (with mesh 86.4% vs 77.3% without mesh, p < 0.001). The complication rate was low, but was more frequent in repeat surgery that were mainly mesh related. The use of mesh was also associated with more frequent de novo UI, but patient satisfaction and cure rates were higher compared with surgery without mesh. Preoperative sensation of a vaginal bulge, severe postoperative complications, anterior colporrhaphy, prior hysterectomy, postoperative infections, local anesthesia, and body mass index (BMI) 30 were risk factors for sensation of a vaginal bulge 1 year postsurgery. Obesity had no effect on complication rates but was associated increased urinary incontinence (UI) after primary surgery. Obesity had no influence on cure or voiding status in women undergoing repeat surgery. Obesity had an impact on the sensation of a vaginal bulge and the presence of UI after primary surgery but not on complications.

Place, publisher, year, edition, pages
Springer London, 2018. Vol. 29, no 1, p. 81-89
Keywords [en]
Body mass index, Mesh, Obesity, Pelvic organ prolapse, Postoperative complications, Urinary continence
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
URN: urn:nbn:se:umu:diva-144089DOI: 10.1007/s00192-017-3446-9ISI: 000419451200011PubMedID: 28894904OAI: oai:DiVA.org:umu-144089DiVA, id: diva2:1178233
Available from: 2018-01-29 Created: 2018-01-29 Last updated: 2018-06-09Bibliographically approved

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Nüssler, EmilLindkvist, Håkan
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Obstetrics and GynecologyDepartment of Mathematics and Mathematical Statistics
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