A comparison of women with primary and recurrent pelvic prolapse

OBJECTIVE: Our purpose was to identify clinically relevant differences in women with primary and recurrent pelvic organ prolapse. STUDY DESIGN: Consecutive women undergoing reconstructive surgery completed a urogynecologic history and physical examination and underwent either multichannel urodynamic testing or pelvic floor fluoroscopy, or both. Two groups were compared: primary (no prior surgery for pelvic organ prolapse) and recurrent. RESULTS: One hundred eighty-one consecutive women were studied - 103 with primary and 78 with recurrent prolapse. The groups were similar with respect to age, race, weight, vaginal parity, prolapse stage, urodynamic diagnosis; extent of visceral malposition, and common urinary, anorectal, and sexual symptoms. Clinically relevant differences were found, with the recurrent group having shorter vaginal lengths (P = .0005), being more likely to have had a hysterectomy for a nonprolapse indication (P = .00018) and to be receiving hormone replacement therapy (P = .00003). CONCLUSION: The women with primary and recurrent pelvic organ prolapse in this population were remarkably similar in many quantifiable parameters measured. The clinical differences may be related to previous surgery for pelvic organ prolapse.