title: Obesity as a risk for the recurrence of anterior vaginal wall prolapse after anterior colporrhaphy.
abstract: OBJECTIVE
  To determine whether obese body mass index is associated with the recurrence of anterior vaginal wall prolapse after anterior colporrhaphy.
  
  
  METHODS
  We conducted a retrospective cohort study of the risk of recurrent anterior prolapse 6 months after anterior colporrhaphy in normal weight/overweight versus obese women from January 2004 to December 2010. Women who underwent a concurrent apical prolapse procedure were excluded. Data were abstracted regarding sociodemographics, physical examination, operative reports, and postoperative follow-up visits.
  
  
  RESULTS
  Of 282 subjects 192 (68%) were normal/overweight and 90 (32%) were obese. Median time of follow-up was 1.8 months (interquartile range [IQR] 1.4-6.2) in the normal/overweight group and 2.0 months (IQR 1.4-5.9) in the obese group. The overall risk of recurrent prolapse was 15.2%. In bivariate analysis there was a trend towards higher recurrence in the obese versus the normal/overweight cohort (21.1% vs. 12.5%, p = 0.06). In the logistic regression model, which adjusted for age, race, diabetes, constipation, cigarette use, concurrent sling, and prior hysterectomy, obesity became significantly associated with recurrent anterior prolapse (odds ratio 2.5, 95% confidence interval 1.2-5.3).
  
  
  CONCLUSIONS
  The risk of recurrence after anterior colporrhaphy is relatively high in the short-term. Obesity is associated with increased odds of anatomic recurrence of anterior vaginal wall prolapse.
authors.affiliation: Department of Obstetrics and Gynecology, Duke University Medical Center, Box 3192, 5324 McFarland Drive, Suite 300, Durham, NC 27707, USA. amie.kawasaki@duke.edu
authors.forename: Amie
authors.initials: A
authors.lastname: Kawasaki
authors.forename: Elizabeth G
authors.initials: EG
authors.lastname: Corey
authors.forename: Robin A
authors.initials: RA
authors.lastname: Laskey
authors.forename: Alison C
authors.initials: AC
authors.lastname: Weidner
authors.forename: Nazema Y
authors.initials: NY
authors.lastname: Siddiqui
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Wu
mesh_terms: D000368:Aged; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D016017:Odds Ratio; D050177:Overweight / Q000150:complications; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D014596:Uterine Prolapse / Q000209:etiology / Q000601:surgery*