title: Vaginal prolapse recurrence after uterosacral ligament suspension in normal-weight compared with overweight and obese women.
abstract: OBJECTIVE
  To compare recurrent prolapse after vaginal uterosacral ligament suspension in normal-weight compared with overweight or obese women.
  
  
  METHODS
  We performed a retrospective cohort study of the risk of recurrent prolapse after uterosacral ligament suspension in normal-weight compared with overweight or obese women at our institution from December 1, 1996, through June 30, 2011. Women with fewer than 6 months of follow-up and those with a prior vault suspension were excluded. Our primary outcome was a composite measure defined as anterior, posterior, or apical prolapse recurrence extending beyond the hymen or repeat treatment for prolapse with surgery or a pessary in women undergoing uterosacral ligament suspension and other vaginal repairs.
  
  
  RESULTS
  We included 219 participants (81 [37%] normal-weight and 138 [63%] overweight or obese women). There was no difference in median follow-up (14 months; interquartile range 8.5-26.5 months] in the normal-weight compared with 13 months [interquartile range 9.0-29.0 months] in the overweight or obese women, P=.98). Prolapse recurred in 22.2% (n=18) of the normal-weight group and 26.1% (n=36) of the overweight or obese group (P=.52). Surgery for recurrent prolapse was performed in 16.0% (n=13) of the normal-weight women and in 14.5% (n=20) of the overweight or obese women (P=.76). The most common site of recurrence was the anterior compartment (17.4% [n=38]) compared with the apical compartment (8.7% [n=19]) or posterior compartment (6.8% [n=15]) with no significant difference between cohorts.
  
  
  CONCLUSIONS
  After uterosacral ligament suspension, overweight or obese women have similar prolapse recurrence compared with normal-weight women. Anterior prolapse is the most common site of recurrence after uterosacral ligament suspension.
authors: Departments of Obstetrics and Gynecology, Duke University, Durham, North Carolina, and Indiana University Health/Methodist Hospital, Indianapolis, Indiana.
authors: Autumn L
authors: AL
authors: Edenfield
authors: Cindy L
authors: CL
authors: Amundsen
authors: Alison C
authors: AC
authors: Weidner
authors: Jennifer M
authors: JM
authors: Wu
authors: Amy
authors: A
authors: George
authors: Nazema Y
authors: NY
authors: Siddiqui
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008022:Ligaments / Q000601:surgery*; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D050177:Overweight / Q000150:complications*; D012008:Recurrence; D012189:Retrospective Studies; D014596:Uterine Prolapse / Q000150:complications* / Q000601:surgery*
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