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International Urogynecology Journal
Published in: International Urogynecology Journal 1/2018

01-01-2018 | Review Article

Risk factors for prolapse recurrence: systematic review and meta-analysis

Authors: Talia Friedman, Guy D. Eslick, Hans Peter Dietz

Published in: International Urogynecology Journal | Issue 1/2018

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Abstract

Introduction and hypothesis

Female pelvic organ prolapse (POP) is a common condition, with a lifetime risk for surgery of 10–20%. Prolapse procedures are known to have a high reoperation rate. It is assumed that etiological factors for POP may also be risk factors for POP recurrence after surgery. There are few reviews available evaluating risk factors for prolapse and recurrence or recently updated meta-analysis on this topic. Our aim was to perform a systematic review and quantitative meta-analysis to determine risk factors for prolapse recurrence after reconstructive surgery.

Methods

Four electronic databases (MEDLINE, PubMed, EMBASE, and Google Scholar) were searched between 1995 and 1 January 2017, with no language restrictions.

Results

Twenty-five studies met inclusion criteria for a total of 5082 patients with an average recurrence rate of 36%. Variables on which a meta-analysis could be performed were body mass index (BMI) (n = 12), age (n = 11), preoperative stage (n = 9), levator avulsion (n = 8), parity (n = 8), constipation/straining (n = 6), number of compartments involved (n = 4), prior hysterectomy (n = 4), familiy history (n = 3), and several other predictors evaluated in only three studies. The following meta- analyses identified significant predictors: levator avulsion [odds ratio (OR) 2.76, P < 0.01], preoperative stage 3–4 (OR 2.11, P < 0.001), family history (OR 1.84, P = 0.006), and hiatal area (OR 1.06/cm2, P = 0.003).

Conclusions

Levator avulsion, prolapse stage, and family history are significant risk factors for prolapse recurrence.
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Metadata
Title
Risk factors for prolapse recurrence: systematic review and meta-analysis
Authors
Talia Friedman
Guy D. Eslick
Hans Peter Dietz
Publication date
01-01-2018
Publisher
Springer London
Published in
International Urogynecology Journal / Issue 1/2018
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-017-3475-4

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