title: Pelvic organ prolapse surgery following hysterectomy on benign indications.
abstract: OBJECTIVE
  The objective of the study was to determine the risk for pelvic organ prolapse surgery attributed to hysterectomy on benign indications
  
  
  METHODS
  In a nationwide longitudinal study, 162,488 women with hysterectomy from 1973 through 2003 were matched to 470,519 population-based control women. Hazard ratios (HR) with 95% confidence interval (CI) were calculated using Cox regression analyses.
  
  
  RESULTS
  In all, 3.2% (n = 5270) of women with hysterectomy had pelvic organ prolapse surgery, compared with 2.0% (n = 9437) in nonhysterectomized controls. Compared with nonhysterectomized controls, the overall HR for prolapse surgery was 1.7 (95% CI, 1.6 to 1.7) with the highest risks observed in women having had a vaginal hysterectomy (HR 3.8; 95% CI, 3.1 to 4.8). Compared with hysterectomized women with no vaginal births, the HR for prolapse surgery was 2.0 (95% CI, 0.9 to 4.1) among women with 1 vaginal childbirth and 11.3 (95 % CI, 6.0. to 21.1) among women with at least 4 vaginal births.
  
  
  CONCLUSIONS
  Hysterectomy is associated with an increased risk for subsequent pelvic organ prolapse surgery with multiparous women at particular risk.
authors: Department of Medical Epidemiology and Biostatistics, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden. daniel.altman@ki.se
authors: Daniel
authors: D
authors: Altman
authors: Christian
authors: C
authors: Falconer
authors: Sven
authors: S
authors: Cnattingius
authors: Fredrik
authors: F
authors: Granath
mesh_terms: D000328:Adult; D015987:Effect Modifier, Epidemiologic; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D010298:Parity; D011183:Postoperative Complications / Q000453:epidemiology; D011247:Pregnancy; D012042:Registries; D012044:Regression Analysis; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D014596:Uterine Prolapse / Q000453:epidemiology*