Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence
Abstract
OBJECTIVE: To determine the incidence of surgically managed pelvic organ prolapse and urinary incontinence in a population-based cohort, and to describe their clinical characteristics. METHODS: Our retrospective cohort study included all patients undergoing surgical treatment for prolapse and incontinence during 1995; all were members of Kaiser Permanente Northwest, which included 149,554 women age 20 or older. A standardized data-collection form was used to review all inpatient and outpatient charts of the 395 women identified. Variables examined included age, ethnicity, height, weight, vaginal parity, smoking history, medical history, and surgical history, including the preoperative evaluation, procedure performed, and details of all prior procedures. Analysis included calculation of age-specific and cumulative incidences and determination of the number of primary operations compared with repeat operations performed for prolapse or incontinence. RESULTS: The age-specific incidence increased with advancing age. The lifetime risk of undergoing a single operation for prolapse or incontinence by age 80 was 11.1%. Most patients were older, postmenopausal, parous, and overweight. Nearly half were current or former smokers and one-fifth had chronic lung disease. Reoperation was common (29.2% of cases), and the time intervals between repeat procedures decreased with each successive repair. CONCLUSION: Pelvic floor dysfunction is a major health issue for older women, as shown by the 11.1% lifetime risk of undergoing a single operation for pelvic organ prolapse and urinary incontinence, as well as the large proportion of reoperations. Our results warrant further epidemiologic research in order to determine the etiology, natural history, and long-term treatment outcomes of these conditions.
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Recurrence in a new compartment may be explained by redistribution of forces to other compartments after the primary operation.
“This could be explained by the concept of redistribution of forces to other compartments after the primary operation, which predisposes them to prolapse [7, 12, 14].”
From Risk factors for recurrence of pelvic organ prolapse after vaginal surgery among Ugandan women: a prospective cohort study (2022) · cites this paper as [7]
The lifetime risk of undergoing surgery to correct POP is 11.9%.
“The lifetime risk of undergoing surgery to correct POP is 11.9% [7, 8] and close to 200,000 women undergo surgery for POP in the USA annually [9, 10].”
From Risk factors for recurrence of pelvic organ prolapse after vaginal surgery among Ugandan women: a prospective cohort study (2022) · cites this paper as [7]
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Self-citationLevator avulsion is a risk factor for cystocele recurrence
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- Authors
- OLSEN, A., SMITH, V, BERGSTROM, J., COLLING, J., & CLARK, A.
- Affiliations
- Oregon Health & Science University (US)
- Kaiser Permanente (US)
- Corresponding author
- OLSEN, A
- Venue
- Obstetrics & Gynecology
- Published
- 1997-04
- Volume
- 89
- Issue
- 4
- Pages
- 501-506
- ISSN
- 0029-7844 (ISSN-L)
- OpenAlex
- W2015635389
- Cited by
- 3,335
- References
- 20
- Citations by year
- 2026: 49 · 2025: 94 · 2024: 102 · 2023: 91 · 2022: 117 · 2021: 127 · 2020: 154 · 2019: 136 · 2018: 133 · 2017: 154 · 2016: 158 · 2015: 131 · 2014: 170 · 2013: 162 · 2012: 220
- FWCI
- 8.58
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
- Health Sciences › Medicine › Obstetrics and Gynecology › Uterine Myomas and Treatments
- Health Sciences › Medicine › Urology › Urinary Bladder and Prostate Research
- Keywords
- pelvic organ prolapse, urinary incontinence, pelvic floor dysfunction, surgical incidence, lifetime risk, reoperation, postmenopausal women, smoking, chronic lung disease, parity, Kaiser Permanente Northwest
- MeSH terms
- Adult, Aged, Aged, 80 and over, Female, Humans, Middle Aged, Retrospective Studies, Urinary Incontinence, Uterine Prolapse, Cohort Studies, Incidence
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