title: Incidence of pelvic organ prolapse repair subsequent to hysterectomy: a comparison between radical hysterectomy and total abdominal hysterectomy.
abstract: OBJECTIVE
  The aim of this study was to compare the incidence of subsequent pelvic organ prolapse (POP) repair in women following radical hysterectomy versus total abdominal hysterectomy.
  
  
  METHODS
  From the Danish National Patient Registry, we collected data on all radical hysterectomies, all total abdominal hysterectomies, and all POP operations performed in Denmark from 1 January 1977 to 31 December 2009. We excluded patients with prior POP repair, POP diagnosis, or concomitant POP repair at hysterectomy. We analyzed the incidence of POP surgery using Kaplan-Meier curves and hazard ratio (HR).
  
  
  RESULTS
  In all, 5279 women underwent radical hysterectomy, and 63 of these underwent subsequent POP surgery. In the same period, 149,920 women underwent total abdominal hysterectomy, and 6107 of these had POP surgery subsequent to the hysterectomy. The cumulative incidence of POP surgery was significantly lower for radical hysterectomy than for abdominal hysterectomy-3.4 % and 9.5 %, respectively, at the end of the study period, yielding a crude HR of 0.36 and an adjusted HR of 0.40 in favor of the radical hysterectomy. The distribution of POP operations in the defined compartments was the same for the two types of hysterectomy.
  
  
  CONCLUSIONS
  This study found a significantly lower incidence of subsequent POP operations among women who undergo radical hysterectomy than total abdominal hysterectomy.
authors.affiliation: Department of Obstetrics and Gynecology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark. rl@runelykke.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, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark.
authors.forename: Jan
authors.initials: J
authors.lastname: Blaakær
authors.affiliation: Juliane Marie Centre, Rigshospitalet, København Ø, 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; D000368:Aged; D003430:Cross-Sectional Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; 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; Pelvic organ prolapse; Radical hysterectomy; Urogynecology