TUCSON, ARIZ. — There is a substantial recurrence rate following surgery for pelvic organ prolapse, particularly in the context of cystocele repair, University of Washington researchers reported at the annual meeting of the Society of Gynecologic Surgeons.
Dr. Michael Fialkow and associates examined records for 142 women who underwent surgery primarily for pelvic organ prolapse in 1993 and were then followed for up to 10 years.
A total of 36 recurrent cases were identified during the 1,050 woman-years studied, for an overall recurrence rate of 3.43 per 100 woman-years.
“A cystocele was the most common site of both primary (87%) and recurrent (75%) prolapse … which is consistent with previous literature documenting the difficulty of repairing this condition durably,” the investigators noted in a poster presented at the meeting.
More than half of the recurrences—21 of 36—developed at the same site as the original prolapse, but 11 patients developed prolapse at a new site and 4 had evidence of recurrent prolapse at the original site and a new occurence elsewhere.
Of note, just 6 patients opted for a surgical repair following recurrence, whereas 16 opted for conservative management, and 14 had no documented management of the recurrent prolapse.
Dr. Fialkow of the university's department of obstetrics and gynecology and another investigator disclosed that they have participated in the speaker's bureau for Pfizer Inc., which makes products used in the treatment of pelvic organ prolapse.
The study's coinvestigators represented the Center for Health Studies of the Group Health Cooperative and the department of epidemiology at the University of Washington, Seattle.