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

被引:164
作者
Friedman, Talia [1 ,2 ]
Eslick, Guy D. [3 ]
Dietz, Hans Peter [1 ]
机构
[1] Univ Sydney, Sydney Med Sch Nepean, Sydney, NSW, Australia
[2] Tel Aviv Univ, Chaim Sheba Med Ctr, Tel Aviv, Israel
[3] Univ Sydney, Whiteley Martin Res Ctr, Discipline Surg, Sydney, NSW, Australia
关键词
Avulsion; Meta-analysis; Pelvic organ prolapse; Recurrence; Risk factors; Surgery; PELVIC ORGAN PROLAPSE; CYSTOCELE RECURRENCE; SURGICAL-MANAGEMENT; LEVATOR AVULSION; SURGERY; WOMEN; FLOOR; REOPERATION; ETIOLOGY; DEFECTS;
D O I
10.1007/s00192-017-3475-4
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
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. Four electronic databases (MEDLINE, PubMed, EMBASE, and Google Scholar) were searched between 1995 and 1 January 2017, with no language restrictions. 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/cm(2), P = 0.003). Levator avulsion, prolapse stage, and family history are significant risk factors for prolapse recurrence.
引用
收藏
页码:13 / 21
页数:9
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