Department of Obstetrics and Gynecology, Lady Davis Carmel Medical Center, Haifa, Israel.
Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Int J Gynaecol Obstet. 2024 Mar;164(3):848-856. doi: 10.1002/ijgo.14999. Epub 2023 Jul 24.
Studies aimed to assess risk factors for pelvic organ prolapse (POP) recurrence following colpocleisis with nonconclusive results.
To investigate risk factors for POP recurrence following colpocleisis.
MEDLINE, PUBMED, Embase, Web of Science, and Cochrane databases were systematically searched.
Experimental and non-experimental studies investigating POP recurrence following colpocleisis.
We assessed the association between preoperative and postoperative physical examination findings, demographics and medical history, and the risk of recurrence following colpocleisis.
A total of 954 studies were identified, of which five studies comprising 2978 patients were eligible for analysis. Both preoperative and postoperative genital hiatus length were significantly longer in the recurrence group (mean difference [MD] 0.48, 95% confidence interval [CI] 0.01-0.94, P = 0.04, I = 0% and MD 1.15, 95% CI 0.50-1.81, P = 0.005, I = 0%; respectively). Preoperative total vaginal length (TVL) did not differ between groups (MD 0.05, 95% CI -0.40 to 0.50, P = 0.83, I = 6%), postoperative TVL was found significantly longer in the recurrence group (MD 0.07, 95% CI -0.03 to 1.38, P = 0.04, I = 68%). Both preoperative and postoperative perineal body did not differ between groups. Women with a previous POP surgery were more likely to experience recurrence following colpocleisis (relative risk 2.09, 95% CI 1.18-3.69, P = 0.01, I = 0%). Patient's age and previous hysterectomy did not affect recurrence rates.
Wider preoperative and postoperative genital hiatus as well as longer post-operative TVL and previous POP surgery were associated with a higher risk for recurrence following colpocleisis, highlighting the importance of appropriate patient selection and surgical technique in minimizing this risk.
旨在评估经阴道闭孔尿道中段悬吊术后盆腔器官脱垂（POP）复发的危险因素的研究结果尚无定论。
探讨经阴道闭孔尿道中段悬吊术后 POP 复发的危险因素。
系统检索了 MEDLINE、PUBMED、Embase、Web of Science 和 Cochrane 数据库。
研究经阴道闭孔尿道中段悬吊术后 POP 复发的实验和非实验性研究。
我们评估了术前和术后体格检查、人口统计学和病史与经阴道闭孔尿道中段悬吊术后复发风险之间的关系。
共确定了 954 项研究，其中 5 项研究共纳入 2978 例患者符合分析条件。复发组的术前和术后生殖器裂孔长度均显著更长（平均差异 [MD] 0.48，95%置信区间 [CI] 0.01-0.94，P = 0.04，I = 0%和 MD 1.15，95% CI 0.50-1.81，P = 0.005，I = 0%；分别）。组间术前总阴道长度（TVL）无差异（MD 0.05，95% CI -0.40 至 0.50，P = 0.83，I = 6%），但术后 TVL 在复发组中显著更长（MD 0.07，95% CI -0.03 至 1.38，P = 0.04，I = 68%）。术前和术后会阴体在组间无差异。既往有 POP 手术史的女性经阴道闭孔尿道中段悬吊术后复发的可能性更高（相对风险 2.09，95% CI 1.18-3.69，P = 0.01，I = 0%）。患者年龄和既往子宫切除术与复发率无关。
术前和术后生殖器裂孔较宽，术后 TVL 较长，既往有 POP 手术史与经阴道闭孔尿道中段悬吊术后复发风险增加相关，这突出了适当的患者选择和手术技术在降低这种风险中的重要性。
