Primary and repeat surgical treatment for female pelvic organ prolapse and incontinence in parous women in the UK: a register linkage study
Open accessAbstract
Objectives: To determine the lifetime risk of undergoing pelvic floor surgery in a cohort of UK parous women and the re-operation rates for pelvic floor surgery, time intervals for repeat surgery and independent risk factors for undergoing primary and repeat pelvic floor surgery. Study design: A register linkage study. Main outcome measures: The primary outcome was lifetime risk of parous women in the UK undergoing pelvic floor surgery for pelvic organ prolapse (POP), urinary incontinence (UI), and rectal prolapse or faecal incontinence (RP-FI). Secondary outcomes were re-operation rates and time interval of repeat surgery for POP/UI, and independent risk factors for undergoing primary and repeat pelvic floor surgery. Results: 34 631 women identified from the Aberdeen Maternity and Neonatal Database were linked with the Scottish Morbidity Records databases of NHS Scotland to assess relevant outcomes. The lifetime risk for women by age 80 years of undergoing any form of pelvic floor surgery was 12.2%. 2130 (6.2%) women had at least one pelvic floor surgery, of whom 407 (19%) had repeat operations. The median time intervals (IQR) between index and repeat UI and POP surgery were 2.80 (0.94–8.07) years and 3 (1.00–8.25) years, respectively. There is a reduced lifetime risk of pelvic floor surgery in women who had all deliveries by caesarean section (p<0.001) and those aged <20 years at first delivery (p=0.021). Women who sustained at least one perineal laceration (in the absence of a classified perineal tear) during delivery or who had at least one instrumental delivery with forceps use were at increased risk (p<0.001 and p=0.015, respectively). Conclusions: Our study shows that in the UK more than one in 10 parous women will require at least one surgical procedure for pelvic floor disorders over their lifetime. The study also identifies independent risk and protective factors for pelvic floor surgery in parous women.
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In a 2011 Scottish registry linkage study of 34,651 women, the lifetime risk of undergoing prolapse surgery by age 80 was 9.5%, with a re-operation rate of 15.8% and a median of 3 years between index and repeat surgery.
“A 2011 Scottish registry linkage study of 34 651 women reported the lifetime risk of a woman undergoing prolapse surgery by the age of 80 was 9.5% with a re‐operation rate of 15.8% and a median of 3 years between index and repeat surgery [1].”
From How Can We Improve the Assessment and Indifferent Outcomes From Pelvic Organ Prolapse Management From Conservative and Surgical Therapies? ICI‐RS 2025 (2026) · cites this paper as [1]
The Results sections report a 9.5% lifetime risk of POP surgery by age 80, a 15.8% POP re-operation rate, and a median of 3.0 years between index and repeat POP surgery. However, the Abstract and Results give the cohort size as 34,631 women, not 34,651. (LLM, conf=0.91)
Experimental — accuracy not yet measuredRecurrence of prolapse after surgical treatment is common.
“However, recurrence of prolapse after surgical treatment is common.”
From How Can We Improve the Assessment and Indifferent Outcomes From Pelvic Organ Prolapse Management From Conservative and Surgical Therapies? ICI‐RS 2025 (2026) · cites this paper as [1]
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Cites
Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence
OLSEN, A., SMITH, V, BERGSTROM, J., COLLING, J., & CLARK, A. (1997) · Obstetrics & Gynecology · doi:10.1016/s0029-7844(97)00058-6 · Cited by 3,335 · see citing works
Lifetime Risk of Undergoing Surgery for Pelvic Organ Prolapse
Smith, F. J., Holman, C. D. J., Moorin, R. E., & Tsokos, N. (2010) · Obstetrics & Gynecology · doi:10.1097/aog.0b013e3181f73729 · Cited by 822 · see citing works
Desforges, J. F., Carlson, K. J., Nichols, D. H., & Schiff, I. (1993) · New England Journal of Medicine · doi:10.1056/nejm199303253281207 · Cited by 335 · see citing works
Clark, A. L., Gregory, T., Smith, V. J., & Edwards, R. (2003) · American Journal of Obstetrics and Gynecology · doi:10.1067/s0002-9378(03)00829-9 · Cited by 290 · see citing works
Hove, M. C. P. S., Pool‐Goudzwaard, A., Eijkemans, M. J. C., Steegers‐Theunissen, R. P. M., Burger, C. W., & Vierhout, M. E. (2009) · International Urogynecology Journal · doi:10.1007/s00192-009-0902-1 · Cited by 266 · see citing works
Imamura, M., Abrams, P., Bain, C., Buckley, B. S., Cardozo, L., Cody, J. D., Cook, J. A., Eustice, S., Glazener, C. M. A., Grant, A. M., et al. (2010) · Health Technology Assessment · doi:10.3310/hta14400 · Cited by 255 · see citing works
Ismail, K., Maissi, E., Thomas, S., Chalder, T., Schmidt, U. H., Bartlett, J. W., Patel, A. K., Dickens, C. M., Creed, F. H., & Treasure, J. L. (2010) · Health Technology Assessment · doi:10.3310/hta14220 · Cited by 244 · see citing works
Lifetime risk of surgical management for pelvic organ prolapse or urinary incontinence
Fialkow, M. F., Newton, K. M., Lentz, G. M., & Weiss, N. S. (2007) · International Urogynecology Journal · doi:10.1007/s00192-007-0459-9 · Cited by 237 · see citing works
The incidence of genital prolapse after the Burch colposuspension
Wiskind, A. K., Creighton, S. M., & Stanton, S. L. (1992) · American Journal of Obstetrics and Gynecology · doi:10.1016/s0002-9378(11)91419-7 · Cited by 211 · see citing works
Perry, S., Shaw, C., Assassa, P., Dallosso, H. M., Williams, K., Brittain, K., Mensah, F. K., Smith, N., Clarke, M., Jagger, C., et al. (2000) · Journal of Public Health · doi:10.1093/pubmed/22.3.427 · Cited by 190 · see citing works
Urinary Incontinence in French Women: Prevalence, Risk Factors, and Impact on Quality of Life
Lasserre, A., Pelat, C., Guéroult, V., et al. (2009) · European Urology · doi:10.1016/j.eururo.2009.04.006 · Cited by 184 · see citing works
Reoperation 10 years after surgically managed pelvic organ prolapse and urinary incontinence
Denman, M. A., Gregory, W. T., Boyles, S. H., Smith, V., Edwards, S. R., & Clark, A. L. (2008) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2008.01.051 · Cited by 180 · see citing works
[Management of urinary incontinence in women].
André, P. (1959) · PubMed · Cited by 173 · see citing works
The age distribution, rates, and types of surgery for pelvic organ prolapse in the USA
Shah, A. D., Kohli, N., Rajan, S. S., & Hoyte, L. P. J. (2007) · International Urogynecology Journal · doi:10.1007/s00192-007-0457-y · Cited by 147 · see citing works
The cost of clinically significant urinary storage symptoms for community dwelling adults in the UK
Turner, D. A., Shaw, C., McGrother, C. W., Dallosso, H. M., Cooper, N. J., & The MRC Incontinence Team (2004) · British Journal of Urology · doi:10.1111/j.1464-410x.2004.04806.x · Cited by 137 · see citing works
MacArthur, C., Glazener, C. M. A., Lancashire, R. J., Herbison, P., Wilson, D., & on behalf of the ProLong study group (2011) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.2011.02964.x · Cited by 102 · see citing works
Papanicolaou, S., Pons, M. E., Hampel, C., et al. (2005) · Maturitas · doi:10.1016/j.maturitas.2005.09.004 · Cited by 69 · see citing works
Prediction of genital prolapse after Burch colposuspension
Kjølhede, P., Rydén, G., & Norén, B. (1996) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.3109/00016349609054715 · Cited by 50 · see citing works
Cesarean section and risk of pelvic organ prolapse: a nested case-control study
Larsson, C., Källén, K., & Andolf, E. G. (2009) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2008.11.028 · Cited by 44 · see citing works
Jacklin, P., Duckett, J., & Renganathan, A. (2010) · International Urogynecology Journal · doi:10.1007/s00192-010-1132-2 · Cited by 18 · see citing works
Distribution of pelvic organ prolapse (POP) in the general population
Hove, M. C. P. S., Bloembergen, H., Vierhout, M. E., et al. (2005) · International Congress Series · doi:10.1016/j.ics.2004.12.046 · Cited by 5 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Lifetime risk of stress urinary incontinence or pelvic organ prolapse surgery
Wu, J. M., Matthews, C. A., Conover, M. M., Pate, V., & Jonsson Funk, M. (2014) · Obstetrics & Gynecology · doi:10.1097/aog.0000000000000286 · Cited by 1,111 · see citing works
Risk factors for pelvic organ prolapse and its recurrence: a systematic review
Vergeldt, T. F. M., Weemhoff, M., IntHout, J., & Kluivers, K. B. (2015) · International Urogynecology Journal · doi:10.1007/s00192-015-2695-8 · Cited by 572 · see citing works
Pessaries (mechanical devices) for managing pelvic organ prolapse in women
Bugge, C., Adams, E. J., Gopinath, D., Stewart, F., Dembinsky, M., Sobiesuo, P., & Kearney, R. (2020) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004010.pub4 · Cited by 80 · see citing works
Delivery mode and the risk of levator muscle avulsion: a meta-analysis
Friedman, T., Eslick, G. D., & Dietz, H. P. (2019) · International Urogynecology Journal · doi:10.1007/s00192-018-3827-8 · Cited by 80 · see citing works
Rahmanou, P., Price, N., & Jackson, S. R. (2015) · International Urogynecology Journal · doi:10.1007/s00192-015-2761-2 · Cited by 62 · see citing works
Laparoscopic hysteropexy: 1- to 4-year follow-up of women postoperatively
Rahmanou, P., White, B., Price, N., & Jackson, S. (2014) · International Urogynecology Journal · doi:10.1007/s00192-013-2209-5 · Cited by 58 · see citing works
Laparoscopic hysteropexy: 10 years’ experience
Jefferis, H., Price, N., & Jackson, S. (2017) · International Urogynecology Journal · doi:10.1007/s00192-016-3257-4 · Cited by 38 · see citing works
Levator hiatal area as a risk factor for cystocele recurrence after surgery: a prospective study
Vergeldt, T., Notten, K., Weemhoff, M., van Kuijk, S., Mulder, F., Beets‐Tan, R., Vliegen, R., Gondrie, E., Bergmans, M., Roovers, J., et al. (2015) · BJOG: An International Journal of Obstetrics & Gynaecology · doi:10.1111/1471-0528.13340 · Cited by 35 · see citing works
Hagen, S., Kearney, R., Goodman, K., Best, C., Elders, A., Melone, L., Dwyer, L., Dembinsky, M., Graham, M., Agur, W., et al. (2023) · eClinicalMedicine · doi:10.1016/j.eclinm.2023.102326 · Cited by 29 · see citing works
Anatomical Cystocele Recurrence: Development and Internal Validation of a Prediction Model
Vergeldt, T. F. M., van Kuijk, S. M. J., Notten, K. J. B., Kluivers, K. B., & Weemhoff, M. (2016) · Obstetrics & Gynecology · doi:10.1097/aog.0000000000001272 · Cited by 25 · see citing works
Brennand, E. A., Scime, N. V., Huang, B., Edwards, A. D., Kim-Fine, S., Hall, J., Birch, C., Robert, M., & Carter Ramirez, A. (2025) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2024.10.021 · Cited by 18 · see citing works
Kearney, R., Wagg, A., Bower, W., Chapple, C., Khullar, V., Robinson, D., Taithongchai, A., Hobson, P. T., Wein, A., & Abrams, P. (2026) · Neurourology and Urodynamics · doi:10.1002/nau.70272 · Cited by 1 · see citing works
- Authors
- Abdel-fattah, M., Familusi, A., Fielding, S., Ford, J., & Bhattacharya, S.
- Affiliations
- University of Aberdeen (GB)
- Venue
- BMJ Open
- Publisher
- BMJ
- Published
- 2011
- Volume
- 1
- Issue
- 2
- Pages
- e000206
- ISSN
- 2044-6055 (ISSN-L)
- PMC
- PMC3221293
- OpenAlex
- W2158623340
- Cited by
- 139
- References
- 21
- Citations by year
- 2026: 8 · 2025: 5 · 2024: 6 · 2023: 9 · 2022: 18 · 2021: 6 · 2020: 11 · 2019: 8 · 2018: 11 · 2017: 8 · 2016: 11 · 2015: 13 · 2014: 10 · 2013: 9 · 2012: 6
- FWCI
- 5.85
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- BMJ Open (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Aberdeen University Research Archive (Aberdeen University) (submittedVersion, cc-by-nc)
- HighWire Press Open Archive (submittedVersion)
- UEA Digital Repository (University of East Anglia) (submittedVersion, cc-by-nc)
- Funders
- University of Aberdeen
- Topics
- Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Health Sciences › Medicine › Obstetrics and Gynecology › Uterine Myomas and Treatments
- Keywords
- pelvic organ prolapse, urinary incontinence, rectal prolapse, fecal incontinence, pelvic floor surgery, reoperation, lifetime risk, parous women, cesarean section, perineal tears, instrumental delivery, risk factors, timing of surgery
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