Trends in Pelvic Organ Prolapse Surgical Repairs: An Analysis of Procedures and Complications

The current study aimed to analyze trends in surgical repair for pelvic organ prolapse (POP) and the characteristics of patients over the past ten years, with a focus on complications during and after surgery.

A retrospective cohort study was conducted at a tertiary medical center, examining POP surgeries and short-term complications in women over 18 from 2014 to 2022. Patients with pelvic radiation, cancer, significant health issues, incomplete records, or who were lost to follow-up were excluded. Complications were evaluated using the Clavien–Dindo Classification, considering infection rates, antibiotic usage, blood transfusions, 30-day readmissions, and ICU admissions. Data analysis included univariate analysis and logistic regression.

The results revealed that

The study involved 490 women, with 239 surgeries in 2014 and 251 in 2022.
A decline in invasive procedures like vaginal hysterectomy (25.1% to 15.1%) and transabdominal hysterectomy (42.7% to 23.1%) was observed, along with an increase in native tissue repairs such as sacrospinous ligament fixation (SSLF) (2.1% to 27.5%), anterior colporrhaphy (14.6% to 24.7%), and posterior colporrhaphy (0.0% to 2.4%).
The use of vaginal mesh also decreased (4.2% to 1.2%).
Short-term complications showed a significant reduction, including infection rates (10.9% to 4.4%), postoperative antibiotic use (10.9% to 4.0%), and blood transfusions (16.7% to 7.6%).
SSLF was identified as an independent protective factor against short-term complications (OR = 0.191, CI 0.044–0.826), after adjusting for the year and patient age.

Thus, the findings indicate a trend towards less invasive surgical options for POP, which may be linked to better short-term outcomes. Moreover, the rise in native tissue repair techniques and the decline in hysterectomies correspond with fewer short-term complications.

Source: Rosenberg H, et al. Trends in patient characteristics, surgical techniques, and associated complications over time in pelvic organ prolapse repair. European Journal of Obstetrics and Gynecology and Reproductive Biology. April 2025. Volume 308, 116 – 120. https://www.ejog.org/article/S0301-2115(25)00123-X/fulltext

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