Comparison of perioperative, long-term complications and recurrence rates after vaginal prolapse surgery by considering ICS POP-Q stage.

Abstract

OBJECTIVE: The aim of this study was to report subjective and objective outcomes and to compare complication and recurrence rate in patients undergoing surgery for International Continence Society (ICS) stage 4 prolapse compared to ICS stage 2 or 3 prolapse. METHODS: We retrospectively reviewed the records of all patients having had surgical treatment for ICS Pelvic Organ Prolapse Quantification (POP-Q) stage 2-4 prolapse between January 2007 and December 2010 at the Yonsei University Severance Hospital. Only patients with ICS POP-Q stage 2-4 prolpase undergoing obliterative procedures or anti-incontinence surgery only were excluded. RESULTS: Three hundred ninety nine patients met inclusion criteria, including 23 with stage 2, 239 with stage 3 and 137 with stage 4 prolapse. The postoperative recurrence rate of preoperative stage IV was 2.4 times higher than that of stage III. There was a significantly higher incidence rates of perioperative and long-term complications, compared to women with other stage prolapse. The mean operative time was significantly greater in the stage 4 group compared to the stage 2, 3 group. CONCLUSION: The overall perioperative complication and recurrence rates in women undergoing surgery for pelvic organ prolapse are low. Women undergoing surgery for ICS POP-Q stage 4 prolapse were found to have a significantly greater blood loss and higher incidence rates of perioperative complications and recurrence, compared with women of other stage.