Is prior pelvic organ surgery associated with prolapse or urinary incontinence?

In a cross-sectional study in The Netherlands, standardized surveys of 1380 women between the ages of 45-85 years were completed for urinary and bowel distress. The women also answered questions about prior pelvic floor surgery.

Prior pelvic floor surgery was recorded by approximately 8.6% of the participants. The likelihood of surgery taking place increased with age, and there was identified greater than 20% chance of prior pelvic floor surgery in the women aged 76-85 years. Higher rates of urinary and defaecatory distress were noted in women who had gone through prior surgery as well.

The factors associated with previous surgery were age, higher body mass index (BMI), pelvic organ prolapse symptoms during pregnancy and prior hernia surgery. The lifetime risk for pelvic organ prolapse surgery is estimated at 20% in The Netherlands.

In the US by the year 2050, research has estimated that pelvic organ prolapse will increase in women by 46% (WU JM 09). Rehabilitation efforts must continue to advance so that women can avoid surgery when possible, and so that women can be offered pre-surgery rehabilitation as well as follow-up post-surgically.