Nina Durchfort Metcalfe1, Lisa M Shandley2, Marisa Rogers Young2, Michelle Higgins3, Chidimma Abanulo4, Gina M Northington2. 1. Department of Gynecology and Obstetrics, Emory University School of Medicine, Emory Gyn/Ob Clinic, 1365 Clifton Road, Bldg A, 4th Floor, Attention Daphne Blow, Atlanta, GA, 30322, USA. Nina.Metcalfe@emory.edu. 2. Department of Gynecology and Obstetrics, Emory University School of Medicine, Emory Gyn/Ob Clinic, 1365 Clifton Road, Bldg A, 4th Floor, Attention Daphne Blow, Atlanta, GA, 30322, USA. 3. Emory University School of Medicine, Atlanta, GA, USA. 4. Women's Healthcare Associates, Portland, OR, USA.
Abstract
INTRODUCTION AND HYPOTHESIS: We hypothesized obesity increases the risk of pelvic organ prolapse recurrence (POP-R) after primary apical prolapse repair. METHODS: We conducted a retrospective cohort study of 353 women who underwent primary apical prolapse surgery from 2011 to 2016. Demographic and clinical data were abstracted from medical records. Multivariable Cox proportional hazard models were used to generate hazard ratios (HR) for association between obesity (BMI ≥ 30 kg/m2) and POP-R (leading edge > 0), adjusting for potential confounders. Given the potential for outcome ascertainment bias due to differential loss to follow-up, a sensitivity analysis was performed assuming all patients with < 6 months of follow-up developed POP-R. RESULTS: Ten percent of women developed POP-R. The median follow-up time was 7 months (range 1.4, 63.9). Twenty-four percent of patients were Black and 70% were White; 37% were obese. After controlling for confounders, obese women did not have an increased risk of POP-R (aHR 1.39; 95% CI 0.67, 2.86, p = 0.38). Although only marginally statistically significant, patients who developed POP-R were more likely to be current smokers (aHR 3.48, 95% CI 1.14, 10.67; p = 0.06) or previous smokers (aHR 1.86, 95% CI 0.82, 4.24, p = 0.06) in comparison to non-smokers. Sensitivity analysis showed loss to follow-up had the potential to influence our results. CONCLUSIONS: Obesity was not a risk factor for POP-R in our cohort. Larger, prospective studies with longer postoperative follow-up time are needed to fully elucidate the relationship between obesity and POP-R.
INTRODUCTION AND HYPOTHESIS: We hypothesized obesity increases the risk of pelvic organ prolapse recurrence (POP-R) after primary apical prolapse repair. METHODS: We conducted a retrospective cohort study of 353 women who underwent primary apical prolapse surgery from 2011 to 2016. Demographic and clinical data were abstracted from medical records. Multivariable Cox proportional hazard models were used to generate hazard ratios (HR) for association between obesity (BMI ≥ 30 kg/m2) and POP-R (leading edge > 0), adjusting for potential confounders. Given the potential for outcome ascertainment bias due to differential loss to follow-up, a sensitivity analysis was performed assuming all patients with < 6 months of follow-up developed POP-R. RESULTS: Ten percent of women developed POP-R. The median follow-up time was 7 months (range 1.4, 63.9). Twenty-four percent of patients were Black and 70% were White; 37% were obese. After controlling for confounders, obese women did not have an increased risk of POP-R (aHR 1.39; 95% CI 0.67, 2.86, p = 0.38). Although only marginally statistically significant, patients who developed POP-R were more likely to be current smokers (aHR 3.48, 95% CI 1.14, 10.67; p = 0.06) or previous smokers (aHR 1.86, 95% CI 0.82, 4.24, p = 0.06) in comparison to non-smokers. Sensitivity analysis showed loss to follow-up had the potential to influence our results. CONCLUSIONS: Obesity was not a risk factor for POP-R in our cohort. Larger, prospective studies with longer postoperative follow-up time are needed to fully elucidate the relationship between obesity and POP-R.
Authors: Lindsay Turner; Erin Lavelle; Jerry L Lowder; Jonathan P Shepherd Journal: Female Pelvic Med Reconstr Surg Date: 2016 Sep-Oct Impact factor: 2.091
Authors: Toya S Pratt; Catherine O Hudson; Gina M Northington; Kristie A Greene Journal: Female Pelvic Med Reconstr Surg Date: 2018 Jan/Feb Impact factor: 2.091
Authors: Emily L Whitcomb; Guri Rortveit; Jeanette S Brown; Jennifer M Creasman; David H Thom; Stephen K Van Den Eeden; Leslee L Subak Journal: Obstet Gynecol Date: 2009-12 Impact factor: 7.661
Authors: Ingrid Nygaard; Linda Brubaker; Halina M Zyczynski; Geoffrey Cundiff; Holly Richter; Marie Gantz; Paul Fine; Shawn Menefee; Beri Ridgeway; Anthony Visco; Lauren Klein Warren; Min Zhang; Susan Meikle Journal: JAMA Date: 2013-05-15 Impact factor: 56.272
Authors: Susan L Hendrix; Amanda Clark; Ingrid Nygaard; Aaron Aragaki; Vanessa Barnabei; Anne McTiernan Journal: Am J Obstet Gynecol Date: 2002-06 Impact factor: 8.661