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Analysis of Risk Factors for Post-Hysterectomy Vaginal Vault Prolapse

Year 2015, , 63 - 71, 09.09.2015
https://doi.org/10.17826/cutf.80376

Abstract

Purpose: To identify risk factors for vaginal vault prolapse after hysterectomy and also estimate incidence of posthysterectomy vault prolapse. Material and Methods: This is a retrospective study of women who underwent hysterectomy for benign indications between January 2010 and December 2012. Medical records were reviewed from two groups of women. Case group was women who had undergone surgery for vault prolapse after hysterectomy; control group was women who were not identified with vault prolapse after hysterectomy by the time of the study. Multivariate regression model identified odds of post-hysterectomy vault prolapse. Results: Of 1758 hysterctomies, 56 (3.19%) were cases. Multivariate regression analysis demonstrated that age at hysterectomy ≥60 years, presence of asthma, previous pelvic organ prolapse surgery, vaginal route of hysterectomy, genital prolapse as indication of hysterectomy, body mass index ≥27 kg/m2 and number of vaginal delivery ≥2 are independent risk factors for development of post-hysterectomy vault prolapse. Conclusions: Vault prolapse after hysterectomy is a relatively rare complication. Elderly age, obesity, chronic obstructive lung diseases, prior genital prolapse sugery, vaginal hysterectomy, genital prolapse as indication of hysterectomy and the number of vaginal delivery ≥2 increase vault prolapse risk. Identification of these risk factors is important to prevent this complication.

References

  • Uzoma A, Farag KA. Vaginal vault prolapse. Obstet Gynecol Int 2009; 2009:275621. doi: 1155/2009/275621. Epub 2009 Aug 11.
  • Mant J, Painter R, Vessey M. Epidemiology of genital prolapse: observations from the Oxford Family Planning Association Study. Br J Obstet Gynaecol 1997;104:579-85.
  • Forsgren C, Zetterström J, López A, Altman D. Risk factors for vaginal vault prolapse surgery in postmenopausal hysterectomized women. Menopause. 2008;15:1115-9.
  • Zhu L, Wang JY, Lang JH, Xu T, Li L. Analysis of prevalence and risk factors of pelvic organ prolapse of women underwent gynecologic health care in Peking Union Medical College Hospital. Zhonghua Fu Chan Ke Za Zhi. 2010;45:501-5.
  • Tinelli A, Malvasi A, Rahimi S, Negro R, Vergara D, Martignago R, et al. Age-related pelvic floor modifications and postmenopausal women. Menopause. 2010;17:204- risk factors in 16. Swift SE, Pound T, Dias JK. Case-control study of
  • MacLennan AH, Taylor AW, Wilson DH, Wilson D. The prevalence of pelvic floor disorders and their relationship to gender, age, parity and mode of delivery. BJOG. 2000;107:1460-70.
  • Dällenbach P, Kaelin-Gambirasio I, Jacob S, Dubuisson JB, Boulvain M. Incidence rate and risk factors for vaginal vault prolapse repair after hysterectomy. Int Urogynecol J Pelvic Floor Dysfunct. 2008;19:1623-9.
  • Baden WF, Walker T. Fundamentals, symptoms and clssification. In: Baden WF, Walker T, eds. Surgigal Repair of Vaginal Defects. Philadelphia, Pa.: Lippincott; 1992;14.
  • Jones HW. Hyterectomy. In: Rock JA and Jones HW, editors. Te Linde’s Operative Gynecology. 9th ed. Philadelphia: Lippincott Williams & Wilkins, 2003;799-824.
  • Segev Y, Auslander R, Lavie O, Lissak A, Abramov Y. Post hysterectomy vaginal vault prolapse: diagnosis prevention and treatment. Harefuah 2008;147:406-12, 478. [ In Hebrew, English abstract ]
  • Hannestad YS, Rortveit G, Hunskaar S. Help- seeking and associated factors in female urinary incontinence. The Norwegian EPINCONT Study. Epidemiology of Incontinence in the County of Nord- Trİndelag. Scand J Prim Health Care. 2002;20:102
  • Marchionni M, Bracco GL, Checcucci V, Carabaneanu A, Coccia EM, Mecacci E. et al. True incidence of vaginal vault prolapse. Thirteen years experience. J Reprod Med 1999;44:679–84.
  • Versi E, Harvey MA, Cardozo L, Brincat M, Studd JW. Urogenital prolapse and atrophy at menopause: A prevalence study. Int Urogynecol J. 2001;12:107
  • Altman D, Falconer C, Cnattingius S, Granath F. Pelvic organ prolapse surgery following hysterectomy on benign indications. Am J Obstet Gynecol. 2008;198:572.e1-6. etiologic factors in the development of severe pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct. 2001;12:1871-92.
  • Maher C, Baessler K, Glazener C, Adams E, Hagen S. Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev. 2004;18:CD004014.
  • Hendrix S, Clark A, Nygaard I, Aragaki A, Barnabei V, McTiernan A. Pelvic organ prolapse in the Women’s Health Initiative: Gravity and gravidity. Am J Obstet Gynecol. 2002;186:1160-6.
  • Turner CE, Young JM, Solomon MJ, Ludlow J, Benness C. Incidence and etiology of pelvic floor dysfunction and mode of delivery: an overview. Dis Colon Rectum 2009;52:1186-95.
  • Dannecker C, Anthuber C. The effects of childbirth on the pelvic-floor. J Perinat Med. 2000;28:175-84.
  • Lukanovic A, Drazic K. Risk factors for vaginal prolapse after hysterectomy. Int J Gynaecol Obstet. 2010;110:27-30.

Histerektomi Sonrasi Vajinal Kuff Prolapsusu İçin Risk Faktörlerinin Analizi

Year 2015, , 63 - 71, 09.09.2015
https://doi.org/10.17826/cutf.80376

Abstract

Amaç: Histerektomi sonrası vajinal kuff prolapsusu için risk faktörlerini belirlemek ve histerektomi sonrası kuff prolapsusu sıklığını tahmin etmek Materyal ve Metod: Bu çalışma, Ocak 2010 ve Aralık 2012 yılları arasında benign sebeplerden dolayı histerektomi yapılan kadınlardan oluşan retrospektif bir çalışmadır. Medikal kayıtlar iki grup hastadan toplanmıştır. Vaka grubu, vajinal kuff prolapsusu için cerrahi uygulanan kadınlar iken kontrol grubu çalışma süresince yapılan histerektomi sonrasında vajinal kuff prolapsusu tesbit edilmeyen kadınlar idi. Çoklu regresyon modeli uygulanarak histerektomi sonrası risk faktörleri tanımlandı. Bulgular: 1758 histerektominin 56 (3.19%) tanesi vaka grubu idi. Çoklu regresyon analizi histerektomi sırasında yaşın ≥60 olmasını, astım, eski pelvik organ prolapsusu cerrahisi varlığını, vajinal yoldan histerektomi yapılmasını, genital prolapsus nedeni ile histerektomi yapılmasını, vücut kitle indeksinin ≥27 kg/m2 ve vajinal doğum sayısının ≥2 olmasını histerektomi sonrası vajinal kuff prolapsusu gelişimi için risk faktörleri olduğunu gözterdi. Araştırma Makalesi / Research Article 63 Kokanalı et al. Cukurova Medical Journal Sonuç: Histerektomi sonrası kuff prolapsusu nadir bir komplikasyondur. İleri yaş, obesite, kronik akciğer hastalığı, önceki genital prolapse cerrahisi, vajinal histerektomi, 2 ve üstü vajinal doğum varlığı kuff prolapsusu riskini arttırmaktadır. Bu risk faktörleri tanımlamak bu komplikasyonu önlemede önemlidir.

References

  • Uzoma A, Farag KA. Vaginal vault prolapse. Obstet Gynecol Int 2009; 2009:275621. doi: 1155/2009/275621. Epub 2009 Aug 11.
  • Mant J, Painter R, Vessey M. Epidemiology of genital prolapse: observations from the Oxford Family Planning Association Study. Br J Obstet Gynaecol 1997;104:579-85.
  • Forsgren C, Zetterström J, López A, Altman D. Risk factors for vaginal vault prolapse surgery in postmenopausal hysterectomized women. Menopause. 2008;15:1115-9.
  • Zhu L, Wang JY, Lang JH, Xu T, Li L. Analysis of prevalence and risk factors of pelvic organ prolapse of women underwent gynecologic health care in Peking Union Medical College Hospital. Zhonghua Fu Chan Ke Za Zhi. 2010;45:501-5.
  • Tinelli A, Malvasi A, Rahimi S, Negro R, Vergara D, Martignago R, et al. Age-related pelvic floor modifications and postmenopausal women. Menopause. 2010;17:204- risk factors in 16. Swift SE, Pound T, Dias JK. Case-control study of
  • MacLennan AH, Taylor AW, Wilson DH, Wilson D. The prevalence of pelvic floor disorders and their relationship to gender, age, parity and mode of delivery. BJOG. 2000;107:1460-70.
  • Dällenbach P, Kaelin-Gambirasio I, Jacob S, Dubuisson JB, Boulvain M. Incidence rate and risk factors for vaginal vault prolapse repair after hysterectomy. Int Urogynecol J Pelvic Floor Dysfunct. 2008;19:1623-9.
  • Baden WF, Walker T. Fundamentals, symptoms and clssification. In: Baden WF, Walker T, eds. Surgigal Repair of Vaginal Defects. Philadelphia, Pa.: Lippincott; 1992;14.
  • Jones HW. Hyterectomy. In: Rock JA and Jones HW, editors. Te Linde’s Operative Gynecology. 9th ed. Philadelphia: Lippincott Williams & Wilkins, 2003;799-824.
  • Segev Y, Auslander R, Lavie O, Lissak A, Abramov Y. Post hysterectomy vaginal vault prolapse: diagnosis prevention and treatment. Harefuah 2008;147:406-12, 478. [ In Hebrew, English abstract ]
  • Hannestad YS, Rortveit G, Hunskaar S. Help- seeking and associated factors in female urinary incontinence. The Norwegian EPINCONT Study. Epidemiology of Incontinence in the County of Nord- Trİndelag. Scand J Prim Health Care. 2002;20:102
  • Marchionni M, Bracco GL, Checcucci V, Carabaneanu A, Coccia EM, Mecacci E. et al. True incidence of vaginal vault prolapse. Thirteen years experience. J Reprod Med 1999;44:679–84.
  • Versi E, Harvey MA, Cardozo L, Brincat M, Studd JW. Urogenital prolapse and atrophy at menopause: A prevalence study. Int Urogynecol J. 2001;12:107
  • Altman D, Falconer C, Cnattingius S, Granath F. Pelvic organ prolapse surgery following hysterectomy on benign indications. Am J Obstet Gynecol. 2008;198:572.e1-6. etiologic factors in the development of severe pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct. 2001;12:1871-92.
  • Maher C, Baessler K, Glazener C, Adams E, Hagen S. Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev. 2004;18:CD004014.
  • Hendrix S, Clark A, Nygaard I, Aragaki A, Barnabei V, McTiernan A. Pelvic organ prolapse in the Women’s Health Initiative: Gravity and gravidity. Am J Obstet Gynecol. 2002;186:1160-6.
  • Turner CE, Young JM, Solomon MJ, Ludlow J, Benness C. Incidence and etiology of pelvic floor dysfunction and mode of delivery: an overview. Dis Colon Rectum 2009;52:1186-95.
  • Dannecker C, Anthuber C. The effects of childbirth on the pelvic-floor. J Perinat Med. 2000;28:175-84.
  • Lukanovic A, Drazic K. Risk factors for vaginal prolapse after hysterectomy. Int J Gynaecol Obstet. 2010;110:27-30.
There are 19 citations in total.

Details

Primary Language English
Journal Section Research
Authors

Mahmut Kokanalı

Sabri Cavkaytar This is me

Hasan Topçu This is me

Coşkun Ümit This is me

Orhan Aksaka This is me

Melike Doğanay This is me

Publication Date September 9, 2015
Published in Issue Year 2015

Cite

MLA Kokanalı, Mahmut et al. “Analysis of Risk Factors for Post-Hysterectomy Vaginal Vault Prolapse”. Cukurova Medical Journal, vol. 40, no. 1, 2015, pp. 63-71, doi:10.17826/cutf.80376.