The effect of age on short-term outcomes after abdominal surgery for pelvic organ prolapse

J Am Geriatr Soc. 2007 Jun;55(6):857-63. doi: 10.1111/j.1532-5415.2007.01178.x.

Abstract

Objectives: To compare perioperative morbidity and 1-year outcomes of older and younger women undergoing surgery for pelvic organ prolapse (POP).

Design: Prospective ancillary analysis.

Setting: Academic medical centers in National Institutes of Health, National Institute of Child Health and Human Development Colpopexy and Urinary Reduction Study.

Participants: Women with POP and no symptoms of stress incontinence.

Intervention: Abdominal sacrocolpopexy with randomization to receive Burch colposuspension for treatment of possible occult incontinence or not.

Measurements: Perioperative complications and Pelvic Organ Prolapse Quantification and quality-of-life (QOL) questionnaires (Pelvic Floor Distress Inventory, Pelvic Floor Impact Questionnaire, and Medical Outcomes Study Short-Form Health Survey (SF-36) preoperatively, immediately postoperatively, and 6 weeks and 3 and 12 months postoperatively).

Results: Three hundred twenty-two women aged 31 to 82 (21% aged > or =70), 93% white. Older women had higher baseline comorbidity (P<.001) and more severe POP (P=.003). Controlling for prolapse stage and whether Burch was performed, there were no age differences in complication rates. Older women had longer hospital stays (3.1+/-1.0 vs 2.7+/-1.5 days, P=.02) and higher prevalence of incontinence at 6 weeks (54.7% vs 37.2%, P=.005). At 3 and 12 months, there were no differences in self-reported incontinence, stress testing for incontinence, or prolapse stage. Improvements from baseline were significant on all QOL measures but with no age differences.

Conclusion: Outcomes of prolapse surgery were comparable between older and younger women except that older women had slightly longer hospital stays.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Female
  • Follow-Up Studies
  • Gynecologic Surgical Procedures / adverse effects
  • Gynecologic Surgical Procedures / methods
  • Humans
  • Laparotomy* / adverse effects
  • Middle Aged
  • Prospective Studies
  • Quality of Life
  • Severity of Illness Index
  • Time Factors
  • Treatment Outcome
  • Uterine Prolapse / surgery*