Department of Pediatrics, Gynecology and Obstetrics, Division of Gynecology, Urogynecology Unit, Geneva University Hospitals, 30 boulevard de la Cluse, 1211, Genève 14, Switzerland.
Faculty of Medicine, University of Geneva, Geneva, Switzerland.
Int Urogynecol J. 2022 Feb;33(2):405-409. doi: 10.1007/s00192-021-04826-7. Epub 2021 May 11.
The objective of our study was to describe the distribution of pelvic organ prolapse (POP) in a population of women undergoing POP reconstructive surgery and to identify compartment-specific risk factors.
We conducted a retrospective observational study in a cohort of 326 women who underwent POP repair and had a standardized preoperative POP assessment using the Baden-Walker classification. The distribution of POP grade was described for each vaginal compartment. The association between the involvement of each specific compartment and predictors was evaluated with a logistic regression model.
The frequency of significant POP (grade ≥ 2) was 79% in the anterior compartment, 49% in the middle/apical compartment and 31% in the posterior compartment. Combined significant anterior and apical defects were present in 25% of women. Increasing age was a significant risk factor for apical defect (between 60 and 70 years OR = 2.4, 95% CI 1.2-4.6; > 70 years OR = 3.4, 95% CI 1.7-6.6). Previous hysterectomy (OR = 2.2, 95% CI 1.0-4.6) was a significant risk factor for posterior defect.
In a population undergoing POP surgery, anterior compartment involvement is the most common and serious defect and can often be associated with an apical defect, especially in older women. In case of previous hysterectomy, the posterior compartment may be weakened. These findings may help surgeons to select the appropriate POP reconstructive surgery, which often should address both anterior and apical defects.
本研究的目的是描述行盆腔器官脱垂（POP）重建手术的女性人群中 POP 的分布，并确定特定部位的风险因素。
我们对 326 例行 POP 修复术的女性进行了回顾性观察性研究，所有患者均使用 Baden-Walker 分类法进行了标准化的术前 POP 评估。描述了每个阴道部位的 POP 分级分布。使用逻辑回归模型评估了每个特定部位的受累情况与预测因子之间的关联。
前盆腔（79%）、中盆腔/顶盆腔（49%）和后盆腔（31%）的显著 POP（分级≥2）发生率分别为 79%、49%和 31%。25%的女性存在前盆腔和顶盆腔同时存在显著缺陷。年龄增长是顶盆腔缺陷的显著危险因素（60-70 岁 OR=2.4，95%CI 1.2-4.6；>70 岁 OR=3.4，95%CI 1.7-6.6）。既往子宫切除术（OR=2.2，95%CI 1.0-4.6）是后盆腔缺陷的显著危险因素。
在接受 POP 手术的人群中，前盆腔受累是最常见和最严重的缺陷，通常与顶盆腔缺陷相关，尤其是在老年女性中。如果既往行子宫切除术，后盆腔可能会减弱。这些发现有助于外科医生选择合适的 POP 重建手术，该手术通常应同时解决前盆腔和顶盆腔缺陷。
