Identification of risk factors for recurrence after pelvic organ prolapse surgery

목적: The aim of our study was to look at different presumed risk factors for prolapse recurrence after ASC. 방법: We performed a retrospective cohort study of the risk of recurrent prolapse after ASC at our institution from March 2005, through December 2014. All women had pelvic surgery with traditional techniques using mesh and were followed to 1 to 5years postoperatively.Our primary outcome was a composite measure defined as prolapse recurrence extending beyond the hymen or presence of bothersome bulging symptoms. We compared those subjects who met the definition of recurrence to those who did not. Statistical analysis was performed using SPSS (version 23). Univariable analysis was done using Student t test, Chi-squre and Fisher’s exact test. Multivariable logistic regression was followed to adjust for confounders. 결과: We included 160 participants at a mean follow-up of 26 months, and 16 women (10%) had a recurrent prolapse. When compared, women with and without prolapse recurrence did not show any significant difference for age, gravity, parity, vaginal parity, menopausal state and hormone replacement therapy. The two groups did not show any significant difference for family history of prolapse, previous hysterectomy status, prolapse operation history. BMI > 30 was the only significant risk factor for recurrence (p=0.02, OR 8.1, 1.6 – 40.1 95% CI). Even though some studies identified that increasing stage of preoperative descent stage increase the risk of recurrence after surgery, there was no difference between stage III and stage IV. (p=0.147, OR 0.4, 0.2 – 1.4 95% CI). In a multivariate model, we found that the risk of recurrence increase as BMI>30 with an odds ratio of 8.8 (95% CI 1.677-46.315) when controlling for age, family history, previous hysterectomy status, prolapse operation history. 결론: After ASC, obese women BMI >30 have higher prolapse recurrence compared with normal-weight women. There was no difference of recurrence between preoperative POP Q stage III and IV.