Reoperation for pelvic organ prolapse: a Danish cohort study with 15–20 years’ follow-up
Abstract
Introduction and hypothesis The objectives were to determine the reoperation rate of primary pelvic organ prolapse (POP) surgery, to describe the age distribution of the women at primary surgery for those undergoing a reoperation, and to describe the incidence of second and third reoperations.Methods We carried out a population-based registry study of Danish women above the age of 18 years when undergoing primary surgery for POP during the period 1996-2000. Data were retrieved from the Danish National Patient Register. All women were followed until one of the following events occurred: reoperation for POP, death, emigration, or end of follow-up period. Reoperation was defined as "repeated surgery in same compartment". The cumulative incidence rate of reoperation was divided into three compartments (anterior, apical, and posterior) and was calculated using Kaplan-Meier plots.Results A total of 18,382 procedures were performed on 11,805 women. After 20 years' follow-up, the cumulated incidence rate of reoperation for POP in the anterior, apical, and posterior compartments was 12.4%, 7.9%, and 12.1% respectively. The overall rate of reoperation was 11.5%. Of women aged between 18 and 49 years of age at primary surgery, 26.9% had a reoperation, whereas in women between 50 and 90+ years of age at primary surgery, only 10.1% had a reoperation.Conclusions This large study with up to 20 years' follow-up has found that reoperation for POP is modest, that the reoperation rate is lowest for the apical compartment, but highest in all three compartments during the first year after primary surgery. The reoperation rate peaks in the group of women who had their primary surgery before the menopause in all three compartments.
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Our data is consistent with previous studies reporting reoperation rates ranging from 10-19% with varying follow-up time between 5-32 years.
“Our data is consistent with previous studies reporting reoperation rates ranging from 10–19% [ 15 , 19 – 23 ] with varying follow-up time between 5–32 years.”
From Recurrent pelvic organ prolapse after hysterectomy; a 10-year national follow-up study (2024) · cites this paper as [15]
High level of expertise in surgeons, surgical skills and techniques involving apical fixation, and urogynecologists performing all POP procedures explains a reasonable part of their low reoperation rates.
“Previous studies have suggested that a high level of expertise in surgeons, surgical skills and techniques involving apical fixation and urogynecologists performing all POP procedures explains a reasonable part of their low reoperation rates [ 15 , 37 ].”
From Recurrent pelvic organ prolapse after hysterectomy; a 10-year national follow-up study (2024) · cites this paper as [15]
Most recurrences take place within five years after hysterectomy, and in this dataset the median time for reoperation was three years, suggesting that the study likely captured most recurrences.
“On the other hand, most of recurrences take place within five years after hysterectomy [ 9 , 15 , 21 , 22 ] and in our dataset, the median time for reoperation was three years, suggesting that we likely were able to capture most recurrences.”
From Recurrent pelvic organ prolapse after hysterectomy; a 10-year national follow-up study (2024) · cites this paper as [15]
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References 18 · Cited by 46
- Authors
- Løwenstein, E., Møller, L. A., Laigaard, J., & Gimbel, H.
- Affiliations
- Sjællands Universitetshospital, Nykøbing F. (DK)
- Zealand University Hospital (DK)
- Corresponding author
- Løwenstein, Ea
- Venue
- International Urogynecology Journal
- Published
- 2017-07-03
- Volume
- 29
- Issue
- 1
- Pages
- 119-124
- ISSN
- 0937-3462 (ISSN-L)
- 1433-3023
- OpenAlex
- W2733351598
- Cited by
- 46
- References
- 18
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 7 · 2023: 6 · 2022: 4 · 2021: 6 · 2020: 6 · 2019: 4 · 2018: 6 · 2017: 1
- FWCI
- 4.06
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Urogynecology Journal (publishedVersion)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- University of Southern Denmark Research Portal (University of Southern Denmark) (submittedVersion)
- Topics
- Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
- Health Sciences › Medicine › Obstetrics and Gynecology › Uterine Myomas and Treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
- Keywords
- pelvic organ prolapse, reoperation, reoperation rate, age at surgery, menopause, anterior compartment, posterior compartment, long-term follow-up
- MeSH terms
- Age Factors, Denmark, Female, Follow-Up Studies, Humans, Recurrence, Registries, Reoperation, Risk Factors, Gynecologic Surgical Procedures, Incidence, Age Distribution, Pelvic Organ Prolapse
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