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Risk Factors for Pelvic Organ Prolapse Repair After Hysterectomy
Oleh:
Dällenbach, Patrick
;
Kaelin-Gambirasio, Isabelle
;
Dubuisson, Jean-Bernard
;
Boulvain, Michel
Jenis:
Article from Journal - ilmiah internasional
Dalam koleksi:
Obstetrics and Gynecology vol. 110 no. 03 (Sep. 2007)
,
page 625.
Ketersediaan
Perpustakaan FK
Nomor Panggil:
O01.K.2007.03
Non-tandon:
1 (dapat dipinjam: 0)
Tandon:
tidak ada
Lihat Detail Induk
Isi artikel
OBJECTIVE: To estimate the incidence and identify the risk factors for pelvic organ prolapse repair after hysterectomy. METHODS: We conducted a case-control study. We identified 6,214 women who underwent hysterectomy in our gynecology department from 1982 to 2002. Cases (n=114) were women who required pelvic organ prolapse surgery after hysterectomy from January 1982 through December 2005. Controls (n=236) were women randomly selected from the same cohort who did not require pelvic organ surgery during the same period. We performed a univariable and a multivariable analysis among 104 cases and 190 controls to identify the variables associated with prolapse repair after hysterectomy. RESULTS: The incidence of pelvic organ prolapse that required surgical correction after hysterectomy was 1.3 per 1,000 women-years. The risk of prolapse repair was 4.7 times higher in women whose initial hysterectomy was indicated by prolapse and 8.0 times higher if preoperative prolapse grade 2 or more was present. Risk factors included preoperative prolapse grade 2 or more (adjusted odds ratio [OR] 12.6, 95% confidence interval [CI] 4.6–34.7), previous pelvic organ prolapse or urinary incontinence surgery (adjusted OR 7.9, 95% CI 1.3–48.2), history of vaginal delivery (adjusted OR 5.0, 95% CI 1.3–19.7), and sexual activity (adjusted OR 6.2, 95% CI 2.7–14.5). Vaginal hysterectomy was not a risk factor when preoperative prolapse was taken into account (adjusted OR 0.7, 95% CI 0.4–1.1). CONCLUSION: Preoperative pelvic organ prolapse and other factors related to pelvic floor weakness were significantly associated with subsequent pelvic floor repair after hysterectomy. Vaginal hysterectomy was not a risk factor.
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