Pelvic organ prolapse after subtotal and total hysterectomy: a long-term follow-up of an open randomised controlled multicentre study
2013 (English)In: British Journal of Obstetrics and Gynecology, ISSN 1470-0328, E-ISSN 1471-0528, Vol. 120, no 12, 1556-1565 p.Article in journal (Refereed) Published
ObjectiveTo 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). DesignLong-term follow-up study of a randomised controlled multicentre study. SettingSeven hospitals and one private clinic in the south-east of Sweden. PopulationOf the 184 women who were eligible from the original trial, 151 (82%) responded to a postal questionnaire and 128 (70%) were clinically examined. MethodsPostal 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 measuresPOP-Q measurements and symptoms of PFD. ResultsFollow-up time was a median of 11.3years. 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. ConclusionsThis 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
2013. Vol. 120, no 12, 1556-1565 p.
Hysterectomy, long-term follow-up, pelvic organ prolapse, pelvic organ prolapse-quantification, randomised trial
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:uu:diva-210551DOI: 10.1111/1471-0528.12399ISI: 000325627200015OAI: oai:DiVA.org:uu-210551DiVA: diva2:664126