Sharif Ismail1, Jonathan Duckett2,3, Diaa Rizk4, Olanrewaju Sorinola5, Dorothy Kammerer-Doak6, Oscar Contreras-Ortiz7, Hazem Al-Mandeel8, Kamil Svabik9, Mitesh Parekh10, Christian Phillips11. 1. Department of Obstetrics and Gynecology, Royal Sussex County Hospital, Brighton and Sussex University Hospitals NHS Trust and Brighton and Sussex Medical School, Brighton, BN2 5BE, East Sussex, UK. sharif212121@hotmail.com. 2. Department of Obstetrics and Gynecology, Medway Hospital NHS Trust, Medway Maritime Hospital, Gillingham and University of Kent, Canterbury, Kent, UK. 3. University of Greenwich, London, UK. 4. Department of Obstetrics and Gynecology, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain. 5. South Warwickshire NHS Foundation Trust, University of Warwick, Coventry, England, UK. 6. Women's Pelvic Specialty Care P.C., University of New Mexico Hospital, Albuquerque, NM, USA. 7. Faculty of Medicine, University of Buenos Aires, Buenos Aires, Argentina. 8. Department of Obstetrics and Gynecology, King Khalid University Hospital and College of Medicine, King Saud University, Riyadh, Saudi Arabia. 9. Department of Obstetrics and Gynecology, Charles University in Prague, Prague, Czech Republic. 10. Genesis Health System, Zanesville, OH, USA. 11. Department of Obstetrics and Gynecology, Hampshire Hospitals NHS Foundation Trust, Basingstoke, Hampshire, UK.
Abstract
INTRODUCTION AND HYPOTHESIS: This committee opinion paper summarizes available evidence about recurrent pelvic organ prolapse (POP) to provide guidance on management. METHOD: A working subcommittee from the International Urogynecological Association (IUGA) Research and Development Committee was formed. The literature regarding recurrent POP was reviewed and summarized by individual members of the subcommittee. Recommendations were graded according to the 2009 Oxford Levels of Evidence. The summary was reviewed by the Committee. RESULTS: There is no agreed definition for recurrent POP and evidence in relation to its evaluation and management is limited. CONCLUSION: The assessment of recurrent POP should entail looking for possible reason(s) for failure, including persistent and/or new risk factors, detection of all pelvic floor defects and checking for complications of previous surgery. The management requires individual evaluation of the risks and benefits of different options and appropriate patient counseling. There is an urgent need for an agreed definition and further research into all aspects of recurrent POP.
INTRODUCTION AND HYPOTHESIS: This committee opinion paper summarizes available evidence about recurrent pelvic organ prolapse (POP) to provide guidance on management. METHOD: A working subcommittee from the International Urogynecological Association (IUGA) Research and Development Committee was formed. The literature regarding recurrent POP was reviewed and summarized by individual members of the subcommittee. Recommendations were graded according to the 2009 Oxford Levels of Evidence. The summary was reviewed by the Committee. RESULTS: There is no agreed definition for recurrent POP and evidence in relation to its evaluation and management is limited. CONCLUSION: The assessment of recurrent POP should entail looking for possible reason(s) for failure, including persistent and/or new risk factors, detection of all pelvic floor defects and checking for complications of previous surgery. The management requires individual evaluation of the risks and benefits of different options and appropriate patient counseling. There is an urgent need for an agreed definition and further research into all aspects of recurrent POP.
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