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International Urogynecology Journal

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01-11-2018 | Original Article

Pelvic floor muscle weakness: a risk factor for anterior vaginal wall prolapse recurrence

Authors: Jeffrey S. Schachar, Hemikaa Devakumar, Laura Martin, Sara Farag, Eric A. Hurtado, G. Willy Davila

Published in: International Urogynecology Journal | Issue 11/2018

Abstract

Introduction and hypothesis

Native tissue vaginal repairs are associated with relatively high levels of recurrence. Systematic reviews have noted that preoperative pelvic floor muscle strength was associated with increased risk of recurrence in the short term.

Methods

This is a retrospective review of patients who underwent a primary reconstructive surgery for anterior compartment vaginal prolapse between 2001 and 2015. Patients were divided into “absent,” “weak” and “good” preoperative PFM strength (aPFM, wPFM and gPFM, respectively) based on a modified Oxford scale. Failure rates were determined by a composite of subjective and objective anatomic outcomes. Subjects who underwent re-operations or procedures for recurrent prolapse of the anterior compartment were considered failures. A p value < 0.05 was considered statistically significant.

Results

Two hundred ninety-nine patients were included. The aPFM (n = 36), wPFM (n = 115) and gPFM (n = 148) groups had similar descriptive statistics, except subjects in the aPFM and wPFM groups were significantly older than the gPFM group (p = 0.008). All groups underwent similar reconstructive surgeries. Average length of follow-up of 143.9 weeks (41 to 717 weeks) was similar among the three groups (p = 0.472). For the primary outcome of composite failure, aPFM had significantly more anterior vaginal wall recurrences than both the wPFM and gPFM groups, 13.89% vs. 3.48% and 4.05%, respectively (p = 0.033).

Conclusions

Patients with preoperative absent pelvic floor muscle strength (nonfunctioning PFM) had a significantly higher anterior vaginal wall recurrence rate than those with weak or good pelvic floor muscle strength.

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Title: Pelvic floor muscle weakness: a risk factor for anterior vaginal wall prolapse recurrence
Authors: Jeffrey S. Schachar
Hemikaa Devakumar
Laura Martin
Sara Farag
Eric A. Hurtado
G. Willy Davila
Publication date: 01-11-2018
Publisher: Springer London
Published in: International Urogynecology Journal / Issue 11/2018
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-018-3626-2

At a glance: The STEP trials

Springer Medicine

Pelvic floor muscle weakness: a risk factor for anterior vaginal wall prolapse recurrence

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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