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Epidemiologic evaluation of reoperation for surgically treated pelvic organ prolapse and urinary incontinence

  • Amanda L Clark
    Correspondence
    Reprint requests: Amanda L. Clark, MD, Division Chief, Urogynecology and Reconstructive Pelvic Surgery, Associate Professor, Obstetrics and Gynecology, 3181 SW Sam Jackson Park Road, L466, Oregon Health and Science University, Portland, OR 97239.
    Affiliations
    From the Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, Oregon Health and Science University and Kaiser Permanente Northwest, Portland, Ore, USA
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  • Thomas Gregory
    Affiliations
    From the Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, Oregon Health and Science University and Kaiser Permanente Northwest, Portland, Ore, USA
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  • Virginia J Smith
    Affiliations
    From the Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, Oregon Health and Science University and Kaiser Permanente Northwest, Portland, Ore, USA
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  • Renee Edwards
    Affiliations
    From the Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, Oregon Health and Science University and Kaiser Permanente Northwest, Portland, Ore, USA
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      Abstract

      Objective

      The purpose of this study was to measure the risk of reoperation for surgically treated pelvic organ prolapse and urinary incontinence in a community-based population.

      Study design

      A 5-year prospective, observational study was conducted of women who had undergone pelvic organ prolapse and urinary incontinence surgery in 1995. The cohort of 376 women was identified by International Classification of Diseases, 9th revision, and current procedural terminology codes in 149,554 reproductive-aged women within the Kaiser Permanente Northwest membership.

      Results

      Thirty-six women underwent 40 cases of reoperation. By survival analysis, 13% of women underwent reoperation by 71 months. Having undergone previous pelvic organ prolapse and urinary incontinence surgery increased the risk of reoperation to 17% compared with 12% for women who underwent a first procedure (log rank, P = .04). No association was observed with age, body mass index, parity, previoushysterectomy not for prolapse, vaginal versus abdominal approach, severity of prolapse, ethnicity, chronic lung disease, smoking, previous corticosteroid use, and estrogen status.

      Conclusions

      Future reoperation is a significant risk of morbidity for women who undergo pelvic organ prolapse and urinary incontinence surgery.

      Keywords

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