title: Risk factors for vaginal vault prolapse surgery in postmenopausal hysterectomized women.
abstract: OBJECTIVE
  The purpose of this study was to identify risk factors for surgery of vaginal vault prolapse in hysterectomized postmenopausal women.
  
  
  METHODS
  We conducted a case-control study. The cases were 117 consecutive postmenopausal hysterectomized women who underwent vaginal vault prolapse surgery at Danderyd Hospital or Karolinska Hospital, Stockholm, between 1996 and 2005. Control participants were 326 age-matched, randomly selected, hysterectomized women with no vaginal vault prolapse surgery, identified from the Swedish Inpatient Register. For participants and controls alike, data on determinants were extracted from patients' records, the Swedish Inpatient Register, and self-report questionnaires. Data were analyzed using nonparametric statistics and logistic regression.
  
  
  RESULTS
  The questionnaire was returned by 90 of 117 participants (77%) and 233 of 326 controls (71%). The mean age at response to the questionnaire was 72.8 (+/- 9.7 SD) and 71.3 (+/- 8.7 SD) years for participants and controls, respectively. In a multivariate analysis, the only predictors at a significant level were age at hysterectomy (odds ratio = 1.04, 95% CI: 1.004-1.08), prolapse or incontinence surgery before hysterectomy (OR = 2.8, 95% CI: 1.0-7.7), and prolapse or incontinence surgery before vaginal vault surgery (OR = 9.1, 95% CI: 3.6-23.4).
  
  
  CONCLUSIONS
  Postmenopausal women with surgically managed pelvic floor disorders are at increased risk of developing vaginal vault prolapse subsequent to a hysterectomy.
authors.affiliation: Division of Obstetrics and Gynecology, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden. catharina.forsgren@ds.se
authors.forename: Catharina
authors.initials: C
authors.lastname: Forsgren
authors.forename: Jan
authors.initials: J
authors.lastname: Zetterström
authors.forename: Annika
authors.initials: A
authors.lastname: López
authors.forename: Daniel
authors.initials: D
authors.lastname: Altman
mesh_terms: D000367:Age Factors; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006306:Health Surveys; D020249:Hormone Replacement Therapy; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D008875:Middle Aged; D016017:Odds Ratio; D017773:Pelvic Floor / Q000601:surgery; D017698:Postmenopause; D012307:Risk Factors; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D014596:Uterine Prolapse / Q000209:etiology / Q000601:surgery*