Tejumola M Adegoke1, Olivera Vragovic2, Christina Deck Yarrington2, Jean-Robert Larrieux2. 1. Department of Obstetrics and Gynecology, Boston University School of Medicine, 85 E. Concord Avenue, 6th Floor, Boston, MA, USA. Tejumola.adegoke@bmc.org. 2. Department of Obstetrics and Gynecology, Boston University School of Medicine, 85 E. Concord Avenue, 6th Floor, Boston, MA, USA.
Abstract
INTRODUCTION AND HYPOTHESIS: The impact of pregnancy on pelvic organ prolapse following surgical repair is not well understood. We describe five cases of pregnancy following uterine-sparing surgical treatment of pelvic organ prolapse. We analyzed the changes in women's Pelvic Organ Prolapse Quantification (POP-Q) scores. We hypothesized there would be significant improvement in anterior and apical prolapse after surgery and no recurrence of prolapse after pregnancy. METHODS: We performed a retrospective review of the electronic medical record for cases of uterine-sparing apical suspension performed between January 2004 and December 2012 at Boston Medical Center. Student's t-test for paired design was used to compare the change in POP-Q score at points Aa, Ba and C obtained at preoperative, postoperative and postpartum visits. RESULTS: Subjects in our series demonstrated significant improvement in their prolapse at all POP-Q points of interest between the pre- and postoperative visits, particularly at point C. There was a slight increase in POP-Q score from the postoperative visit to the postpartum visit, but this change was not statistically significant. CONCLUSIONS: Our findings are consistent with previous literature, suggesting that the results of uterine-sparing apical prolapse repair are maintained after pregnancy. Women may be counseled to consider surgical prolapse repair even if they have not completed childbearing.
INTRODUCTION AND HYPOTHESIS: The impact of pregnancy on pelvic organ prolapse following surgical repair is not well understood. We describe five cases of pregnancy following uterine-sparing surgical treatment of pelvic organ prolapse. We analyzed the changes in women's Pelvic Organ Prolapse Quantification (POP-Q) scores. We hypothesized there would be significant improvement in anterior and apical prolapse after surgery and no recurrence of prolapse after pregnancy. METHODS: We performed a retrospective review of the electronic medical record for cases of uterine-sparing apical suspension performed between January 2004 and December 2012 at Boston Medical Center. Student's t-test for paired design was used to compare the change in POP-Q score at points Aa, Ba and C obtained at preoperative, postoperative and postpartum visits. RESULTS: Subjects in our series demonstrated significant improvement in their prolapse at all POP-Q points of interest between the pre- and postoperative visits, particularly at point C. There was a slight increase in POP-Q score from the postoperative visit to the postpartum visit, but this change was not statistically significant. CONCLUSIONS: Our findings are consistent with previous literature, suggesting that the results of uterine-sparing apical prolapse repair are maintained after pregnancy. Women may be counseled to consider surgical prolapse repair even if they have not completed childbearing.
Entities:
Keywords:
Pelvic organ prolapse; Pregnancy; Sacrohysteropexy; Uterine preservation
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