Vaginal prolapse recurrence after uterosacral ligament suspension in normal-weight compared with overweight and obese women.

OBJECTIVE: To compare recurrent prolapse after vaginal uterosacral ligament suspension in normal-weight compared with overweight or obese women. METHODS: We performed a retrospective cohort study of the risk of recurrent prolapse after uterosacral ligament suspension in normal-weight compared with overweight or obese women at our institution from December 1, 1996, through June 30, 2011. Women with fewer than 6 months of follow-up and those with a prior vault suspension were excluded. Our primary outcome was a composite measure defined as anterior, posterior, or apical prolapse recurrence extending beyond the hymen or repeat treatment for prolapse with surgery or a pessary in women undergoing uterosacral ligament suspension and other vaginal repairs. RESULTS: We included 219 participants (81 [37%] normal-weight and 138 [63%] overweight or obese women). There was no difference in median follow-up (14 months; interquartile range 8.5-26.5 months] in the normal-weight compared with 13 months [interquartile range 9.0-29.0 months] in the overweight or obese women, P=.98). Prolapse recurred in 22.2% (n=18) of the normal-weight group and 26.1% (n=36) of the overweight or obese group (P=.52). Surgery for recurrent prolapse was performed in 16.0% (n=13) of the normal-weight women and in 14.5% (n=20) of the overweight or obese women (P=.76). The most common site of recurrence was the anterior compartment (17.4% [n=38]) compared with the apical compartment (8.7% [n=19]) or posterior compartment (6.8% [n=15]) with no significant difference between cohorts. CONCLUSIONS: After uterosacral ligament suspension, overweight or obese women have similar prolapse recurrence compared with normal-weight women. Anterior prolapse is the most common site of recurrence after uterosacral ligament suspension.

Duke Scholars

Author Alison Catherine Weidner Obstetrics and Gynecology, Urogynecology

Author Cindy Louise Amundsen Obstetrics and Gynecology, Urogynecology

Author Nazema Yusuf Siddiqui Obstetrics and Gynecology, Urogynecology