A comparison of women with primary and recurrent pelvic prolapse

OBJECTIVE: Our purpose was to identify clinically relevant differences in w omen with primary and recurrent pelvic organ prolapse. STUDY DESIGN: Consecutive women undergoing reconstructive surgery completed a urogynecologic history and physical examination and underwent either mul tichannel urodynamic testing or pelvic floor fluoroscopy, or both. Two grou ps were compared: primary (no prior surgery for pelvic organ prolapse) and recurrent. RESULTS: One hundred eighty-one consecutive women were studied-103 with pri mary and 78 with recurrent prolapse. The groups were similar with respect t o age, race, weight, vaginal parity, prolapse stage, urodynamic diagnosis, extent of visceral malposition, and common urinary, anorectal, and sexual s ymptoms. Clinically relevant differences were found, with the recurrent gro up 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 t his population were remarkably similar in many quantifiable parameters meas ured. The clinical differences may be related to previous surgery for pelvi c organ prolapse.