Non-Oral Poster 51
Relationship between POP-Q Stage of Pelvic Organ Prolapse and Surgery Performed

https://doi.org/10.1016/j.jmig.2014.12.083Get rights and content

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Objectives

Using the pelvic organ prolapse quantification system (POP-Q), we evaluated whether preoperative stage of pelvic organ prolapse (POP) is associated with the subsequent surgical procedure performed and whether the use of synthetic mesh is related to initial prolapse stage.

Materials and Methods

We retrospectively reviewed 1298 POP procedures performed within the Urogynecology Division of a tertiary academic medical center from January 2008-December 2011. The analysis was limited to ≥Stage II POP. Apical repair was required and colpocleisis was excluded, resulting in 821 subjects for analysis. Significant associations between preoperative POP-Q and subsequent procedure were determined by multinomial logistic regression adjusted for age, body mass index (BMI), parity, menopausal status,

Results

The majority of patients were white (96.6%) and postmenopausal (83.8%) with mean age = 60.1 ± 9.8 years, BMI = 27.8 ± 4.8 kg/m2 and median parity = 2 (IQR = 2-3). The majority had ≥1 prior vaginal delivery (98.4%) and 7.3% were current tobacco users. The majority had Stage III prolapse (n = 628, 76.5%). Of 821 procedures, there were 134 native tissue repairs (16.3%), 151 vaginal mesh repairs (18.4%) and 536 sacrocolpopexies (65.3%) [Table 1].

Unadjusted and adjusted multinomial logistic

Conclusion

After adjusting for covariates which may impact surgical choice, patients with lower preoperative POP-Q stage were more likely to undergo a native tissue repair than either a vaginal mesh repair or a sacrocolpopexy. Prolapse stage did not impact whether a sacrocolpopexy or vaginal mesh was performed when only mesh-based repairs were considered.

DISCLOSURE OF RELEVANT FINANCIAL RELATIONSHIPS:

  • Lauren E. Giugale: Nothing to disclose

  • Laura C. Skoczylas: Nothing to disclose

  • Andrew D. Althouse: Nothing

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