Risk factors for pelvic organ prolapse and its recurrence: a systematic review

Tineke F M Vergeldt, Mirjam Weemhoff, Joanna IntHout, Kirsten B Kluivers, Tineke F M Vergeldt, Mirjam Weemhoff, Joanna IntHout, Kirsten B Kluivers

Abstract

Introduction and hypothesis: Pelvic organ prolapse (POP) is a common condition with multifactorial etiology. The purpose of this systematic review was to provide an overview of literature on risk factors for POP and POP recurrence.

Methods: PubMed and Embase were searched with "pelvic organ prolapse" combined with "recurrence" and combined with "risk factors," with Medical Subject Headings and Thesaurus terms and text words variations until 4 August 2014, without language or publication date restrictions. Only cohort or cross-sectional studies carried out in western developed countries containing multivariate analyses and with a definition of POP based on anatomical references were included. POP recurrence had to be defined as anatomical recurrence after native tissue repair without mesh. Follow-up after surgery should have been at least 1 year. Articles were excluded if POP was not a separate entity or if it was unclear whether the outcome was primary POP or recurrence.

Results: PubMed and Embase revealed 2,988 and 4,449 articles respectively. After preselection, 534 articles were independently evaluated by two researchers, of which 15 met the selection criteria. In 10 articles on primary POP, 30 risk factors were investigated. Parity, vaginal delivery, age, and body mass index (BMI) were significantly associated in at least two articles. In 5 articles on POP recurrence, 29 risk factors were investigated. Only preoperative stage was significantly associated in at least two articles.

Conclusion: Parity, vaginal delivery, age, and BMI are risk factors for POP and preoperative stage is a risk factor for POP recurrence.

Keywords: Pelvic organ prolapse; Recurrence; Risk factors.

Figures

Fig. 1
Fig. 1
Flow diagram of the selection process

References

    1. Dietz HP. The aetiology of prolapse. Int Urogynecol J Pelvic Floor Dysfunct. 2008;19(10):1323–1329. doi: 10.1007/s00192-008-0695-7.
    1. Delancey JO, Kane Low L, Miller JM, Patel DA, Tumbarello JA (2008) Graphic integration of causal factors of pelvic floor disorders: an integrated life span model. Am J Obstet Gynecol 199(6):610 e611–615. doi:10.1016/j.ajog.2008.04.001
    1. Schaffer JI, Wai CY, Boreham MK. Etiology of pelvic organ prolapse. Clin Obstet Gynecol. 2005;48(3):639–647. doi: 10.1097/01.grf.0000170428.45819.4e.
    1. Bump RC, Norton PA. Epidemiology and natural history of pelvic floor dysfunction. Obstet Gynecol Clin N Am. 1998;25(4):723–746. doi: 10.1016/S0889-8545(05)70039-5.
    1. Swift SE, Tate SB, Nicholas J. Correlation of symptoms with degree of pelvic organ support in a general population of women: what is pelvic organ prolapse? Am J Obstet Gynecol. 2003;189(2):372–377. doi: 10.1067/S0002-9378(03)00698-7.
    1. Slieker-ten Hove MC, Pool-Goudzwaard AL, Eijkemans MJ, Steegers-Theunissen RP, Burger CW, Vierhout ME. Prediction model and prognostic index to estimate clinically relevant pelvic organ prolapse in a general female population. Int Urogynecol J Pelvic Floor Dysfunct. 2009;20(9):1013–1021. doi: 10.1007/s00192-009-0903-0.
    1. Subak LL, Waetjen LE, van den Eeden S, Thom DH, Vittinghoff E, Brown JS. Cost of pelvic organ prolapse surgery in the United States. Obstet Gynecol. 2001;98(4):646–651. doi: 10.1016/S0029-7844(01)01472-7.
    1. Abdel-Fattah M, Familusi A, Fielding S, Ford J, Bhattacharya S. Primary and repeat surgical treatment for female pelvic organ prolapse and incontinence in parous women in the UK: a register linkage study. BMJ Open. 2011;1(2):e000206. doi: 10.1136/bmjopen-2011-000206.
    1. Wu JM, Hundley AF, Fulton RG, Myers ER. Forecasting the prevalence of pelvic floor disorders in U.S. Women: 2010 to 2050. Obstet Gynecol. 2009;114(6):1278–1283. doi: 10.1097/AOG.0b013e3181c2ce96.
    1. Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL. Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol. 1997;89(4):501–506. doi: 10.1016/S0029-7844(97)00058-6.
    1. Salvatore S, Siesto G, Serati M. Risk factors for recurrence of genital prolapse. Curr Opin Obstet Gynecol. 2010;22(5):420–424. doi: 10.1097/GCO.0b013e32833e4974.
    1. Peduzzi P, Concato J, Kemper E, Holford TR, Feinstein AR. A simulation study of the number of events per variable in logistic regression analysis. J Clin Epidemiol. 1996;49(12):1373–1379. doi: 10.1016/S0895-4356(96)00236-3.
    1. Swift S, Woodman P, O'Boyle A, Kahn M, Valley M, Bland D, Wang W, Schaffer J. Pelvic Organ Support Study (POSST): the distribution, clinical definition, and epidemiologic condition of pelvic organ support defects. Am J Obstet Gynecol. 2005;192(3):795–806. doi: 10.1016/j.ajog.2004.10.602.
    1. Dietz HP, Franco AV, Shek KL, Kirby A. Avulsion injury and levator hiatal ballooning: two independent risk factors for prolapse? An observational study. Acta Obstet Gynecol Scand. 2012;91(2):211–214. doi: 10.1111/j.1600-0412.2011.01315.x.
    1. Nygaard I, Bradley C, Brandt D. Pelvic organ prolapse in older women: prevalence and risk factors. Obstet Gynecol. 2004;104(3):489–497. doi: 10.1097/01.AOG.0000136100.10818.d8.
    1. Whitcomb EL, Rortveit G, Brown JS, Creasman JM, Thom DH, Van Den Eeden SK, Subak LL. Racial differences in pelvic organ prolapse. Obstet Gynecol. 2009;114(6):1271–1277. doi: 10.1097/AOG.0b013e3181bf9cc8.
    1. Handa VL, Blomquist JL, Knoepp LR, Hoskey KA, McDermott KC, Munoz A. Pelvic floor disorders 5-10 years after vaginal or cesarean childbirth. Obstet Gynecol. 2011;118(4):777–784.
    1. Glazener C, Elders A, Macarthur C, Lancashire RJ, Herbison P, Hagen S, Dean N, Bain C, Toozs-Hobson P, Richardson K, McDonald A, McPherson G, Wilson D. Childbirth and prolapse: long-term associations with the symptoms and objective measurement of pelvic organ prolapse. BJOG. 2013;120(2):161–168. doi: 10.1111/1471-0528.12075.
    1. Yeniel AO, Ergenoglu AM, Askar N, Itil IM, Meseri R. How do delivery mode and parity affect pelvic organ prolapse? Acta Obstet Gynecol Scand. 2013;92(7):847–851. doi: 10.1111/aogs.12129.
    1. Progetto Menopausa Italia Study Group (2000) Risk factors for genital prolapse in non-hysterectomized women around menopause: Results from a large cross-sectional study in menopausal clinics in Italy. Eur J Obstet Gynecol Reprod Biol 93:135–140
    1. Kudish BI, Iglesia CB, Gutman RE, Sokol AI, Rodgers AK, Gass M, O'Sullivan MJ, Larson J, Abu-Sitta M, Howard BV. Risk Factors for Prolapse Development in White, Black, and Hispanic Women. Female Pelvic Med Reconstr Surg. 2011;17(2):80–90. doi: 10.1097/SPV.0b013e31820e5d06.
    1. Whiteside JL, Weber AM, Meyn LA, Walters MD. Risk factors for prolapse recurrence after vaginal repair. Am J Obstet Gynecol. 2004;191(5):1533–1538. doi: 10.1016/j.ajog.2004.06.109.
    1. Salvatore S, Athanasiou S, Digesu GA, Soligo M, Sotiropoulou M, Serati M, Antsaklis A, Milani R. Identification of risk factors for genital prolapse recurrence. Neurourol Urodyn. 2009;28(4):301–304. doi: 10.1002/nau.20639.
    1. Diez-Itza I, Aizpitarte I, Becerro A. Risk factors for the recurrence of pelvic organ prolapse after vaginal surgery: a review at 5 years after surgery. Int Urogynecol J Pelvic Floor Dysfunct. 2007;18(11):1317–1324. doi: 10.1007/s00192-007-0321-0.
    1. Weemhoff M, Vergeldt TF, Notten K, Serroyen J, Kampschoer PH, Roumen FJ. Avulsion of puborectalis muscle and other risk factors for cystocele recurrence: a 2-year follow-up study. Int Urogynecol J. 2012;23(1):65–71. doi: 10.1007/s00192-011-1524-y.
    1. Tegerstedt G, Hammarstrom M. Operation for pelvic organ prolapse: a follow-up study. Acta Obstet Gynecol Scand. 2004;83(8):758–763. doi: 10.1111/j.0001-6349.2004.00468.x.
    1. Bodner-Adler B, Shrivastava C, Bodner K. Risk factors for uterine prolapse in Nepal. Int Urogynecol J Pelvic Floor Dysfunct. 2007;18(11):1343–1346. doi: 10.1007/s00192-007-0331-y.
    1. Awwad J, Sayegh R, Yeretzian J, Deeb ME. Prevalence, risk factors, and predictors of pelvic organ prolapse: a community-based study. Menopause. 2012;19(11):1235–1241. doi: 10.1097/gme.0b013e31826d2d94.
    1. Lien YS, Chen GD, Ng SC. Prevalence of and risk factors for pelvic organ prolapse and lower urinary tract symptoms among women in rural Nepal. Int J Gynaecol Obstet. 2012;119(2):185–188. doi: 10.1016/j.ijgo.2012.05.031.
    1. Wong V, Shek KL, Goh J, Krause H, Martin A, Dietz HP. Cystocele recurrence after anterior colporrhaphy with and without mesh use. Eur J Obstet Gynecol Reprod Biol. 2014;172:131–135. doi: 10.1016/j.ejogrb.2013.11.001.
    1. Committee on Gynecologic Practice Vaginal placement of synthetic mesh for pelvic organ prolapse. Female Pelvic Med Reconstr Surg. 2012;18(1):5–9.
    1. Altman DG. Systematic reviews of evaluations of prognostic variables. BMJ. 2001;323(7306):224–228. doi: 10.1136/bmj.323.7306.224.
    1. Van den Berg T, Heymans MW, Leone SS, Vergouw D, Hayden JA, Verhagen AP, de Vet HC (2013) Overview of data-synthesis in systematic reviews of studies on outcome prediction models. BMC Med Res Methodol 13:42. doi:10.1186/1471-2288-13-42
    1. Kapoor DS, Nemcova M, Pantazis K, Brockman P, Bombieri L, Freeman RM. Reoperation rate for traditional anterior vaginal repair: analysis of 207 cases with a median 4-year follow-up. Int Urogynecol J. 2010;21(1):27–31. doi: 10.1007/s00192-009-0991-x.
    1. Weber AM, Abrams P, Brubaker L, Cundiff G, Davis G, Dmochowski RR, Fischer J, Hull T, Nygaard I, Weidner AC. The standardization of terminology for researchers in female pelvic floor disorders. Int Urogynecol J Pelvic Floor Dysfunct. 2001;12(3):178–186. doi: 10.1007/PL00004033.
    1. Salvatore S, Siesto G, Rizk DE. Definition of recurrence of pelvic organ prolapse: is it really important? Int Urogynecol J. 2011;22(6):635–636. doi: 10.1007/s00192-011-1424-1.

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