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Pelvic organ prolapse after subtotal and total hysterectomy: a long-term follow-up of an open randomised controlled multicentre study
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Division of Obstetrics and Gynaecology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences and Department of Obstetrics and Gynaecology, Linköping University County Council of Östergötland, Linköping, Sweden.ORCID iD: 0000-0002-0071-4383
Division of Obstetrics and Gynaecology; Department of Clinical and Experimental Medicine; Faculty of Health Sciences and Department of Obstetrics and Gynaecology; Linköping University, County Council of Östergötland; Linköping Sweden.
2013 (English)In: British Journal of Obstetrics and Gynecology, ISSN 1470-0328, E-ISSN 1471-0528, Vol. 120, no 12, p. 1556-1565Article in journal (Refereed) Published
Abstract [en]

Objective: To analyse the development of pelvic organ prolapse (POP) after subtotal (SH) and total hysterectomy (TH) in the long-term, and to assess patient-reported symptoms regarding pelvic floor dysfunction (PFD).

Design: Long-term follow-up study of a randomised controlled multicentre study.

Setting: Seven hospitals and one private clinic in the south-east of Sweden.

Population: Of the 184 women who were eligible from the original trial, 151 (82%) responded to a postal questionnaire and 128 (70%) were clinically examined.

Methods: Postal questionnaire using the short-form version of the Pelvic Floor Distress Inventory (PFDI-20) and clinical examination using the POP-Q system. Multivariate analyses were used.

Main outcome measures: POP-Q measurements and symptoms of PFD.

Results: Follow-up time was a median of 11.3 years. Less than 3% had stage-3 prolapse. No significant difference was found in the presence of stage-2 or higher stage prolapse between the two hysterectomy groups (39% in SH versus 37% in TH; OR 1.28, 95%CI 0.59-2.80). Nor was there any significant difference in the quality-of-life measurement between the SH and TH groups [summary score PFDI-20: median 93 (range 60-201) versus 87 (range 60-186); Fisher's protected least significant difference post hoc test, P=0.78 ). None of the symptoms of PFD revealed statistically significant differences between the hysterectomy groups.

Conclusions: This long-term follow-up study of PFD showed basically no significant differences in subjective or objective measurements of POP, or in specific pelvic floor quality-of-life aspects after SH and TH. However, because of the low statistical power the results are inconclusive. Larger trials, and probably also a longer follow-up period, are necessary.

Place, publisher, year, edition, pages
Blackwell Publishing, 2013. Vol. 120, no 12, p. 1556-1565
Keywords [en]
Hysterectomy, long-term follow-up, pelvic organ prolapse, pelvic organ prolapse-quantification, randomised trial
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
URN: urn:nbn:se:oru:diva-107878DOI: 10.1111/1471-0528.12399ISI: 000325627200015Scopus ID: 2-s2.0-84886903869OAI: oai:DiVA.org:oru-107878DiVA, id: diva2:1792018
Funder
Linköpings universitetMedical Research Council of Southeast Sweden (FORSS)Available from: 2023-08-28 Created: 2023-08-28 Last updated: 2024-01-02Bibliographically approved

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