Obesity as a risk for the recurrence of anterior vaginal wall prolapse after anterior colporrhaphy.

OBJECTIVE: To determine whether obese body mass index is associated with the recurrence of anterior vaginal wall prolapse after anterior colporrhaphy. STUDY DESIGN: We conducted a retrospective cohort study of the risk of recurrent anterior prolapse 6 months after anterior colporrhaphy in normal weight/overweight versus obese women from January 2004 to December 2010. Women who underwent a concurrent apical prolapse procedure were excluded. Data were abstracted regarding sociodemographics, physical examination, operative reports, and postoperative follow-up visits. RESULTS: Of 282 subjects 192 (68%) were normal/overweight and 90 (32%) were obese. Median time of follow-up was 1.8 months (interquartile range [IQR] 1.4-6.2) in the normal/overweight group and 2.0 months (IQR 1.4-5.9) in the obese group. The overall risk of recurrent prolapse was 15.2%. In bivariate analysis there was a trend towards higher recurrence in the obese versus the normal/overweight cohort (21.1% vs. 12.5%, p = 0.06). In the logistic regression model, which adjusted for age, race, diabetes, constipation, cigarette use, concurrent sling, and prior hysterectomy, obesity became significantly associated with recurrent anterior prolapse (odds ratio 2.5, 95% confidence interval 1.2-5.3). CONCLUSION: The risk of recurrence after anterior colporrhaphy is relatively high in the short-term. Obesity is associated with increased odds of anatomic recurrence of anterior vaginal wall prolapse.

Duke Scholars

Author Alison Catherine Weidner Obstetrics and Gynecology, Urogynecology

Author Nazema Y. Siddiqui Obstetrics and Gynecology, Urogynecology

Author Amie Kawasaki Obstetrics and Gynecology, Urogynecology