title: Risk factors for pelvic organ prolapse and its recurrence: a systematic review.
abstract: OBJECTIVE
  Pelvic organ prolapse (POP) is a common condition with multifactorial etiology. The purpose of this systematic review was to provide an overview of literature on risk factors for POP and POP recurrence.
  
  
  METHODS
  PubMed and Embase were searched with "pelvic organ prolapse" combined with "recurrence" and combined with "risk factors," with Medical Subject Headings and Thesaurus terms and text words variations until 4 August 2014, without language or publication date restrictions. Only cohort or cross-sectional studies carried out in western developed countries containing multivariate analyses and with a definition of POP based on anatomical references were included. POP recurrence had to be defined as anatomical recurrence after native tissue repair without mesh. Follow-up after surgery should have been at least 1 year. Articles were excluded if POP was not a separate entity or if it was unclear whether the outcome was primary POP or recurrence.
  
  
  RESULTS
  PubMed and Embase revealed 2,988 and 4,449 articles respectively. After preselection, 534 articles were independently evaluated by two researchers, of which 15 met the selection criteria. In 10 articles on primary POP, 30 risk factors were investigated. Parity, vaginal delivery, age, and body mass index (BMI) were significantly associated in at least two articles. In 5 articles on POP recurrence, 29 risk factors were investigated. Only preoperative stage was significantly associated in at least two articles.
  
  
  CONCLUSIONS
  Parity, vaginal delivery, age, and BMI are risk factors for POP and preoperative stage is a risk factor for POP recurrence.
authors.affiliation: Department of Obstetrics and Gynecology, Radboud University Medical Center, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands. tinekevergeldt@gmail.com.
authors.forename: Tineke F M
authors.initials: TF
authors.lastname: Vergeldt
authors.affiliation: Department of Obstetrics and Gynecology, Atrium Medical Center Parkstad, Heerlen, The Netherlands.
authors.forename: Mirjam
authors.initials: M
authors.lastname: Weemhoff
authors.affiliation: Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Joanna
authors.initials: J
authors.lastname: IntHout
authors.affiliation: Department of Obstetrics and Gynecology, Radboud University Medical Center, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands.
authors.forename: Kirsten B
authors.initials: KB
authors.lastname: Kluivers
mesh_terms: D005260:Female; D006801:Humans; D056887:Pelvic Organ Prolapse / Q000453:epidemiology* / Q000601:surgery; D012008:Recurrence; D012307:Risk Factors
keywords: Pelvic organ prolapse; Recurrence; Risk factors