title: Age at hysterectomy as a predictor for subsequent pelvic organ prolapse repair.
abstract: OBJECTIVE
  The aim of this study was to investigate the association between patient age at the time of hysterectomy and subsequent pelvic organ prolapse (POP) surgery.
  
  
  METHODS
  We gathered data on all benign hysterectomies and POP surgeries performed in Denmark on Danish women from 1977 to 2009 from the Danish National Patient Registry. The cohort consisted of 154,882 hysterectomized women, who were followed up for up to 32 years. Survival analysis for each age group at hysterectomy was performed using Kaplan-Meier product limit methods.
  
  
  RESULTS
  For all hysterectomized women, we found that low age at hysterectomy yielded a lower risk of subsequent POP surgery than did hysterectomy at an older age. This difference diminished after stratification by indication; all non-POP hysterectomies had a low cumulative incidence at 8-11 % at the end of the follow-up period. For all women hysterectomized, the predominant compartment for POP surgery was the posterior. Women hysterectomized when aged over 66 years had a higher proportion of POP surgery in the apical compartment than in the other age groups (p = 0.000).
  
  
  CONCLUSIONS
  Our findings indicate that age at hysterectomy only marginally influences the risk of subsequent POP surgery for women hysterectomized for indications other than POP. If POP is the indication for hysterectomy, the risk of undergoing subsequent POP surgery increases substantially.
authors.affiliation: Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark. runelykk@rm.dk.|Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark. runelykk@rm.dk.
authors.forename: Rune
authors.identifier: http://orcid.org/0000-0001-7756-8575
authors.initials: R
authors.lastname: Lykke
authors.affiliation: Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Jan
authors.initials: J
authors.lastname: Blaakær
authors.affiliation: Juliane Marie Centre, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Bent
authors.initials: B
authors.lastname: Ottesen
authors.affiliation: Department of Obstetrics and Gynecology, Nykøbing Falster Hospital, Nykøbing Falster, Denmark.
authors.forename: Helga
authors.initials: H
authors.lastname: Gimbel
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000706:statistics & numerical data*; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000453:epidemiology* / Q000601:surgery*; D012042:Registries; D012307:Risk Factors
keywords: Hysterectomy; Kaplan–Meier; Pelvic organ prolapse; Urogynecology