Factors involved in prolapse recurrence one year after anterior vaginal repair

Diez-Itza, Irene; Avila, Marisa; Uranga, Sabiñe; Belar, Maria; Lekuona, Arantza; Martín, A.

doi:10.1007/s00192-020-04468-1

Cited by 12 publications

(14 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The detailed characteristics of each of the studies included are presented in Table 1 . Of the 12 articles included, 3 were prospective [ 31 , 33 , 38 ] and 9 retrospective studies [ 12 , 28 – 30 , 32 , 34 – 37 ]. A total of 2,637 subjects were analysed, of which at least 1,055 had a diagnosis of either unilateral or bilateral levator ani avulsion.…”

Section: Resultsmentioning

confidence: 99%

“…Only 3 studies described objective prolapse recurrence in all compartments [ 12 , 32 , 38 ]. Seven studies described recurrence limited to the anterior compartment [ 28 , 30 , 31 , 34 – 37 ]. One study described a “composite optimal outcome” as a determinant of success [ 33 ], whereby an “optimal outcome” was a predefined measurement in both the anterior and the mid compartment.…”

Section: Resultsmentioning

confidence: 99%

“…All studies diagnosed LAMA using 4D translabial ultrasound in the method described by Dietz et al [ 39 ]. In 4 studies, LAMA was diagnosed preoperatively [ 12 , 31 , 33 , 38 ] and in 6 studies [ 30 , 32 , 34 – 37 ], LAMA was diagnosed postoperatively. In one study, LAMA was diagnosed pre- and postoperatively [ 29 ] and in another, ultrasound assessment was performed either pre- or postoperatively [ 28 ].…”

Section: Resultsmentioning

confidence: 99%

“…Seven studies published ORs or raw data able to be analysed for LAMA risk for subjective prolapse recurrence. However, as only one single study [ 31 ] adjusted for confounding factors, we were unable to pool adjusted odds ratios.

Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Three studies [ 12 , 31 , 33 ] described reoperation rates for prolapse recurrence when reporting follow-up results. The rate of reoperation was low in all three studies and was 1.5%, 0.9% and 1.05% respectively.…”

Section: Resultsmentioning

confidence: 99%

See 4 more Smart Citations

Is levator ani avulsion a risk factor for prolapse recurrence? A systematic review and meta-analysis

2022

View full text Add to dashboard Cite

Introduction and hypothesis Levator ani muscle avulsion as a risk factor for prolapse recurrence is not well established. This systematic review was aimed at evaluating the correlation between levator ani avulsion and postoperative prolapse recurrence with meta-analysis, specifically, the risk of subjective or objective prolapse recurrence and reoperation. Methods The protocol was registered in the International Prospective Register of Systematic Reviews (registration number CRD42021256675). A systematic literature search was conducted using PubMed, EMBASE and Cochrane Database of Systematic Reviews to identify all peer-reviewed studies that described levator avulsion in women and investigated operative and postoperative outcomes. All peer-reviewed, English-language cohort studies in those with and without levator avulsion with a minimum of 3 months’ follow-up were included. Pooled unadjusted and adjusted odds ratios were calculated for subjective recurrence, objective recurrence and rates of re-operation. The Cochrane Collaboration Risk of Bias In Non-Randomized Studies (RoBINS) and The Grading of Recommendations Assessment, Development and Evaluation (GRADE) tools were used to assess the quality of the studies included. Results Twelve studies with a total of 2,637 subjects and a follow-up period 0.3–6.4 years were identified. There were insufficient data to report a pooled adjusted risk for subjective recurrence and reoperation. On low to moderate quality-adjusted data, the pooled odds of objective recurrence was not significantly associated with levator ani avulsion (aOR 1.68; 95% CI 0.78–3.66). Conclusion Levator ani avulsion has not been confirmed as a risk factor for objective prolapse recurrence. Further evidence is needed to investigate the correlation between levator ani avulsion and the risk of subjective recurrence and reoperation.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Fig.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Is levator ani avulsion a risk factor for prolapse recurrence? A systematic review and meta-analysis

2022

View full text Add to dashboard Cite

show abstract

Value of pelvic examination in women with pelvic organ prolapse: A systematic review

Pizzoferrato,

Sallée,

Thubert

et al. 2024

Intl J Gynecology & Obste

View full text Add to dashboard Cite

BackgroundRecent recommendations from the French High Authority of Health on pelvic organ prolapse (POP) management underline the value of a pelvic examination.ObjectivesThe aim of this paper was to analyze the literature and identify the best evidence available regarding pelvic examination for women presenting prolapse‐associated symptoms in terms of diagnosis and predictability of treatment success.Search StrategyThe databases were queried similarly using Medical Subject Headings (MeSH) and non‐MeSH terms broadly related to pelvic examination and POP management.Selection CriteriaWe included studies assessing the diagnostic contribution of pelvic examination (correlation with symptoms) and its value for assessing the risk of pessary failure or recurrence after reconstructive surgery.Data Collection and AnalysisWe assessed peer‐reviewed articles on PubMed, Embase, and Cochrane database up to May 2023. The methodological quality of all the included studies was assessed using the ROBINS‐E or RoB2 tools.Main ResultsIn all, 67 studies were retained for the review. Prolapse‐associated symptoms are poorly correlated with POP diagnosis. The symptom that is best correlated with the POP stage is the presence of a vaginal bulge (moderate to good correlation). The factors most strongly associated with the risk of recurrence after surgery or pessary failure are clinical: essentially a higher POP stage before surgery, levator ani muscle avulsion, and vaginal and genital measurements.ConclusionsIn women complaining of prolapse‐associated symptoms, a pelvic examination (vaginal speculum and digital vaginal examination) can confirm the presence of POP and identify risk factors for treatment failure or recurrence after surgical management or pessary placement. A higher stage of POP and levator ani muscle avulsion—discernible on pelvic examination—are major risk factors for POP recurrence or treatment failure. These features must be taken into account in the treatment choice and discussed with the patient.

show abstract

The impact of levator ani muscle trauma and contraction on recurrence after prolapse surgery

et al. 2022

View full text Add to dashboard Cite

Introduction and hypothesis The objective was to explore the impact of levator ani muscle (LAM) trauma and pelvic floor contraction on symptoms and anatomy after pelvic organ prolapse (POP) surgery. Methods Prospective study including 200 women with symptomatic POP ≥ grade 2 examined 3 months prior to and 6 months after surgery. Prolapse in each compartment was graded using the Pelvic Organ Prolapse Quantification (POP-Q) system, and women answered yes/no to a question about bulge sensation. Pelvic floor muscle contraction was assessed with transperineal ultrasound measuring proportional change in levator hiatal anteroposterior diameter from rest to contraction. LAM trauma was diagnosed using tomographic ultrasound imaging. Statistical analysis was performed using multivariate logistic regression analysis. Results A total of 183 women (92%) completed the study. Anatomical recurrence (POP ≥ grade 2) was found in 76 women (42%), and a bulge sensation was reported by 35 (19%). Ninety-two women (50%) had LAM trauma, and this was associated with increased risk of anatomical recurrence (OR 2.1 (95% CI 1.1–4.1), p = 0.022), but not bulge sensation (OR 1.1 (95% CI 0.5–2.4), p = 0.809). We found a reduced risk of bulge sensation for women with absent to weak contraction compared with normal to strong contraction (OR 0.4 (95% CI 0.1–0.9), p = 0.031), but no difference in risk for POP ≥ 2 after surgery (OR 1.5 (95% CI 0.8–2.9), p = 0.223). Conclusions Levator ani muscle trauma was associated with increased risk of anatomical failure 6 months after POP surgery. Absent to weak pelvic floor muscle contraction was associated with reduced risk of bulge sensation after surgery.

show abstract

Factors involved in prolapse recurrence one year after anterior vaginal repair

Cited by 12 publications

References 25 publications

Is levator ani avulsion a risk factor for prolapse recurrence? A systematic review and meta-analysis

Is levator ani avulsion a risk factor for prolapse recurrence? A systematic review and meta-analysis

Value of pelvic examination in women with pelvic organ prolapse: A systematic review

The impact of levator ani muscle trauma and contraction on recurrence after prolapse surgery

Contact Info

Product

Resources

About