Risk factors for pelvic floor repair after hysterectomy

Adil Eddie Bharucha, Roberta E. Blandon, L. Joseph Melton, Cathy D. Schleck, Alan R. Zinsmeister, John B. Gebhart

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

OBJECTIVE:: Having demonstrated that prior history of prolapse was a risk factor for pelvic floor repair procedures after hysterectomy, the objective of this study was to assess medical risk factors for pelvic floor repair after hysterectomy. METHODS:: Using the Rochester Epidemiology Project database of 8,220 Olmsted County, Minnesota, women who had hysterectomy for benign indications from 1965-2002, we conducted a nested case-control study in 144 pairs, comparing women who underwent pelvic floor repair after hysterectomy (case group) with women matched for known risk factors (ie, age, pelvic floor disorders at baseline, year and type of hysterectomy, and pelvic floor repair during hysterectomy) (control group). RESULTS:: The median duration between hysterectomy and pelvic floor repair was 13 years. Chronic pulmonary disease (odds ratio [OR] 14.3, 95% confidence interval [CI] 1.2-178), but not obstetric history, obesity, indication for hysterectomy, or chronic constipation, was associated with an increased risk of pelvic floor repair after hysterectomy. Between the hysterectomy and subsequent pelvic floor repair, overall pelvic organ prolapse severity changed by one grade or less in 54 case patients (38%, group A) but increased by two or more grades in 72 case patients (50%, group B). In group A, but not group B, uterine prolapse (OR 25, 95% CI 2.1-300) and chronic pulmonary disease (OR 22, 95% CI 1.5-328) at baseline remained risk factors for pelvic floor repair after hysterectomy. CONCLUSION:: In this matched case-control study, chronic pulmonary disease was the only risk factor for pelvic floor repair after hysterectomy for benign indications, underscoring the need to address pulmonary status before surgery.

Original languageEnglish (US)
Pages (from-to)601-608
Number of pages8
JournalObstetrics and Gynecology
Volume113
Issue number3
DOIs
StatePublished - Mar 2009

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Pelvic Floor
Hysterectomy
Lung Diseases
Chronic Disease
Odds Ratio
Confidence Intervals
Case-Control Studies
Pelvic Floor Disorders
Uterine Prolapse
Pelvic Organ Prolapse
Prolapse
Constipation
Obstetrics
Epidemiology
Obesity
History

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Bharucha, A. E., Blandon, R. E., Melton, L. J., Schleck, C. D., Zinsmeister, A. R., & Gebhart, J. B. (2009). Risk factors for pelvic floor repair after hysterectomy. Obstetrics and Gynecology, 113(3), 601-608. https://doi.org/10.1097/AOG.0b013e3181998998

Risk factors for pelvic floor repair after hysterectomy. / Bharucha, Adil Eddie; Blandon, Roberta E.; Melton, L. Joseph; Schleck, Cathy D.; Zinsmeister, Alan R.; Gebhart, John B.

In: Obstetrics and Gynecology, Vol. 113, No. 3, 03.2009, p. 601-608.

Research output: Contribution to journalArticle

Bharucha, AE, Blandon, RE, Melton, LJ, Schleck, CD, Zinsmeister, AR & Gebhart, JB 2009, 'Risk factors for pelvic floor repair after hysterectomy', Obstetrics and Gynecology, vol. 113, no. 3, pp. 601-608. https://doi.org/10.1097/AOG.0b013e3181998998
Bharucha AE, Blandon RE, Melton LJ, Schleck CD, Zinsmeister AR, Gebhart JB. Risk factors for pelvic floor repair after hysterectomy. Obstetrics and Gynecology. 2009 Mar;113(3):601-608. https://doi.org/10.1097/AOG.0b013e3181998998
Bharucha, Adil Eddie ; Blandon, Roberta E. ; Melton, L. Joseph ; Schleck, Cathy D. ; Zinsmeister, Alan R. ; Gebhart, John B. / Risk factors for pelvic floor repair after hysterectomy. In: Obstetrics and Gynecology. 2009 ; Vol. 113, No. 3. pp. 601-608.
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AU - Melton, L. Joseph

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AU - Zinsmeister, Alan R.

AU - Gebhart, John B.

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N2 - OBJECTIVE:: Having demonstrated that prior history of prolapse was a risk factor for pelvic floor repair procedures after hysterectomy, the objective of this study was to assess medical risk factors for pelvic floor repair after hysterectomy. METHODS:: Using the Rochester Epidemiology Project database of 8,220 Olmsted County, Minnesota, women who had hysterectomy for benign indications from 1965-2002, we conducted a nested case-control study in 144 pairs, comparing women who underwent pelvic floor repair after hysterectomy (case group) with women matched for known risk factors (ie, age, pelvic floor disorders at baseline, year and type of hysterectomy, and pelvic floor repair during hysterectomy) (control group). RESULTS:: The median duration between hysterectomy and pelvic floor repair was 13 years. Chronic pulmonary disease (odds ratio [OR] 14.3, 95% confidence interval [CI] 1.2-178), but not obstetric history, obesity, indication for hysterectomy, or chronic constipation, was associated with an increased risk of pelvic floor repair after hysterectomy. Between the hysterectomy and subsequent pelvic floor repair, overall pelvic organ prolapse severity changed by one grade or less in 54 case patients (38%, group A) but increased by two or more grades in 72 case patients (50%, group B). In group A, but not group B, uterine prolapse (OR 25, 95% CI 2.1-300) and chronic pulmonary disease (OR 22, 95% CI 1.5-328) at baseline remained risk factors for pelvic floor repair after hysterectomy. CONCLUSION:: In this matched case-control study, chronic pulmonary disease was the only risk factor for pelvic floor repair after hysterectomy for benign indications, underscoring the need to address pulmonary status before surgery.

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