Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China.
Department of Acupuncture and Massage, Zibo Central Hospital, Shandong University, Zibo, China.
J Obstet Gynaecol. 2023 Dec;43(1):2160929. doi: 10.1080/01443615.2022.2160929.
Female pelvic organ prolapse (POP) is a common condition, which has a high recurrence rate after reconstructive surgery, and the risk factors for POP recurrence are unclear. The aim of this study was to perform a meta-analysis to determine risk factors for POP recurrence. A thorough search of PubMed, Medline, EMBASE, Cochrane Central Register of Controlled Trials, and China Academic Journal Network Publishing Database was conducted for relevant publications until 29 October 2022, without language restrictions. A total of 29 studies involving 6597 patients were included, and the recurrence rate of POP after surgery was 37.7%. Significant OR and CI were found for levator avulsion (OR: 2.46, 95% CI: 1.80-3.36), preoperative stage ≥ III (OR: 1.87, 95% CI: 1.53-2.27), hiatal area on Valsalva manoeuvre (OR: 1.08, 95% CI: 1.03-1.12) and previous pelvic floor surgery (OR: 1.60, 95% CI: 1.07-2.39). Levator avulsion, preoperative stage ≥ III, hiatal area on Valsalva manoeuvre and previous pelvic floor surgery are significant risk factors for POP recurrence.IMPACT STATEMENT It has been reported that genetic factors, parity, obesity, birth-induced injury during delivery, etc. are risk factors for POP development and recurrence after operation. There are few literatures about the risk factors of POP recurrence at present. Our research has increased the information regarding risk factors for POP recurrence. Our study provides an overview of the risk factors affecting POP recurrence and their contribution (OR, CI) to POP recurrence, which provides valuable evidence-based basis for clinical decision-making in POP treatment and prevention of POP recurrence.
女性盆腔器官脱垂（POP）是一种常见疾病，重建手术后复发率较高，POP 复发的危险因素尚不清楚。本研究旨在进行荟萃分析以确定 POP 复发的危险因素。对 PubMed、Medline、EMBASE、Cochrane 中央对照试验注册库和中国学术期刊网络出版数据库进行了全面检索，检索截至 2022 年 10 月 29 日，无语言限制。共纳入 29 项研究，涉及 6597 例患者，手术后 POP 的复发率为 37.7%。发现会阴撕裂（OR：2.46，95%CI：1.80-3.36）、术前分期≥III 期（OR：1.87，95%CI：1.53-2.27）、Valsalva 动作时疝口面积（OR：1.08，95%CI：1.03-1.12）和既往盆底手术（OR：1.60，95%CI：1.07-2.39）与 POP 复发显著相关。会阴撕裂、术前分期≥III 期、Valsalva 动作时疝口面积和既往盆底手术是 POP 复发的显著危险因素。
重要性声明：已有研究报道，遗传因素、产次、肥胖、分娩时产伤等是 POP 发生和术后复发的危险因素。目前关于 POP 复发的危险因素的文献较少。本研究增加了有关 POP 复发危险因素的信息。本研究概述了影响 POP 复发的危险因素及其对 POP 复发的贡献（OR，CI），为 POP 治疗和预防 POP 复发的临床决策提供了有价值的循证依据。
