De novo rectal prolapse after obliterative and reconstructive vaginal surgery for urogenital prolapse.
OBJECTIVE
The purpose of this study was to compare the incidence of de novo rectal prolapse after obliterative vaginal surgery with the incidence that was seen after reconstructive vaginal surgery for urogenital prolapse.


METHODS
A chart review was performed on subjects who underwent vaginal surgery for urogenital prolapse from Jan. 1, 2001, through Dec. 31, 2004, at the Cleveland Clinic. Diagnosis of postoperative rectal prolapse was identified with ICD-9 code 569.1.


RESULTS
Nine hundred sixteen women underwent vaginal surgery for urogenital prolapse. Ninety-two percent of the women (n = 840) underwent reconstructive surgery, and 8% of the women (n = 76) underwent obliterative surgery. The incidence of postoperative full-thickness rectal prolapse in women who were > or = 65 years old who underwent obliterative surgery was 3 of 74 (4.1%; 95% CI, 1.4-11), with an estimated odds ratio of 22 (95% CI, 2.3-196; P < .002) compared with women who were > or = 65 years old who underwent reconstructive surgery.


CONCLUSIONS
Obliterative surgery is associated with a substantially greater risk of de novo rectal prolapse than reconstructive vaginal surgery for urogenital prolapse.
Collins
Sarah A
SA
Section of Urogynecology and Reconstructive Pelvic Surgery, Division of Surgery, Department of Gynecology and Obstetrics, Cleveland Clinic Foundation, Cleveland, OH, USA.
Jelovsek
J Eric
JE
Chen
Chi Chiung Grace
CC
Gustilo-Ashby
A Marcus
AM
Barber
Matthew D
MD
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D012005:Rectal Prolapse / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D016896:Treatment Outcome; D014596:Uterine Prolapse / Q000150:complications / Q000601:surgery*; D014621:Vagina / Q000601:surgery