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Recurrent pelvic organ prolapse: International Urogynecological Association Research and Development Committee opinion

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Abstract

Introduction and hypothesis

This committee opinion paper summarizes available evidence about recurrent pelvic organ prolapse (POP) to provide guidance on management.

Method

A working subcommittee from the International Urogynecological Association (IUGA) Research and Development Committee was formed. The literature regarding recurrent POP was reviewed and summarized by individual members of the subcommittee. Recommendations were graded according to the 2009 Oxford Levels of Evidence. The summary was reviewed by the Committee.

Results

There is no agreed definition for recurrent POP and evidence in relation to its evaluation and management is limited.

Conclusion

The assessment of recurrent POP should entail looking for possible reason(s) for failure, including persistent and/or new risk factors, detection of all pelvic floor defects and checking for complications of previous surgery. The management requires individual evaluation of the risks and benefits of different options and appropriate patient counseling. There is an urgent need for an agreed definition and further research into all aspects of recurrent POP.

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Notes

  1. http://www.cebm.net/oxford-centre-evidence-based-medicine-levels-evidence-march-2009/accessed on 28.1.2016 at 09:00 GMT.

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Acknowledgements

The kind help provided by the Brighton and Sussex NHS Library and Knowledge Team in performing a literature search and providing articles, and by the Manager of Educational Programs at the International Urogynecological Association’s Headquarters, Amanda Grabloski, in co-ordinating all exchanges between the authors, is acknowledged.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Royal Sussex County Hospital, Brighton and Sussex University Hospitals NHS Trust and Brighton and Sussex Medical School, Brighton, BN2 5BE, East Sussex, UK

    Sharif Ismail

  2. Department of Obstetrics and Gynecology, Medway Hospital NHS Trust, Medway Maritime Hospital, Gillingham and University of Kent, Canterbury, Kent, UK

    Jonathan Duckett

  3. University of Greenwich, London, UK

    Jonathan Duckett

  4. Department of Obstetrics and Gynecology, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain

    Diaa Rizk

  5. South Warwickshire NHS Foundation Trust, University of Warwick, Coventry, England, UK

    Olanrewaju Sorinola

  6. Women’s Pelvic Specialty Care P.C., University of New Mexico Hospital, Albuquerque, NM, USA

    Dorothy Kammerer-Doak

  7. Faculty of Medicine, University of Buenos Aires, Buenos Aires, Argentina

    Oscar Contreras-Ortiz

  8. Department of Obstetrics and Gynecology, King Khalid University Hospital and College of Medicine, King Saud University, Riyadh, Saudi Arabia

    Hazem Al-Mandeel

  9. Department of Obstetrics and Gynecology, Charles University in Prague, Prague, Czech Republic

    Kamil Svabik

  10. Genesis Health System, Zanesville, OH, USA

    Mitesh Parekh

  11. Department of Obstetrics and Gynecology, Hampshire Hospitals NHS Foundation Trust, Basingstoke, Hampshire, UK

    Christian Phillips

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  1. Sharif Ismail
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  2. Jonathan Duckett
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  7. Hazem Al-Mandeel
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  8. Kamil Svabik
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Correspondence to Sharif Ismail.

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Disclaimer

This Committee Opinion was developed by the International Urogynecological Association Research and Development Committee. The information is designed to aid practitioners in making decisions about appropriate urogynecological care and should not be construed as dictating an exclusive course of treatment or procedure. Variations in practice may be warranted based on the needs of the individual patient, resources, and limitations unique to the institution or type of practice.

Conflicts of interest

J. Duckett is the Chairman of the British Society of Urogynaecology Research Committee, has received travel expenses, speaker honoraria and research grants from Astellas, Ethicon, American Medical Systems, Pfizer, and Lilly, and acts as a consultant to Astellas and Ethicon. H. Al-Mandeel has received travel expenses and speaker honoraria from Ethicon and Saja. K. Svabik received travel expenses and speaker honoraria from and acts as a consultant to Astellas. C. Philips has received travel expenses and speaker honoraria from Ethicon. M. Parekh has received travel expenses and speaker honoraria from and acts as a consultant to Boston Scientific and Astellas. S. Ismail, D. Rizk, O. Sorinola, D. Kammerer-Doak, and O. Contreras-Ortiz have no conflicts of interest.

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Ismail, S., Duckett, J., Rizk, D. et al. Recurrent pelvic organ prolapse: International Urogynecological Association Research and Development Committee opinion. Int Urogynecol J 27, 1619–1632 (2016). https://doi.org/10.1007/s00192-016-3076-7

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  • DOI: https://doi.org/10.1007/s00192-016-3076-7

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