Lifetime Risk of Undergoing Surgery for Pelvic Organ Prolapse

TLDR

The study aims to estimate the lifetime risk of first‑time pelvic organ prolapse surgery, updating earlier estimates derived from managed‑care cohorts. Using age‑specific incidence rates from 44,728 cases between 1981 and 2005, the authors applied a life‑table method to estimate cumulative lifetime risk to age 85 and calculated age‑standardized rates to illustrate secular trends. The analysis found a 19% lifetime risk of POP surgery in the general female population, higher than the 11–12% reported in managed‑care cohorts, indicating a substantial burden that warrants enhanced prevention and early intervention strategies.

Abstract

In Brief OBJECTIVE: To investigate the lifetime risk of first-time incident pelvic organ prolapse (POP) surgery with the intention of updating previous risk estimates that have been based on members of managed-care populations. METHODS: Age-specific incidence rates of first-time prolapse surgery between 1981 and 2005 were calculated based on 44,728-incident cases. We estimated the lifetime risk as the cumulative incidence to age 85 years based on a life-table method and using the most recent cross-sectional incidence rates for the period 2001–2005. Age-standardized rates by calendar year were also calculated to show the secular trend in prolapse surgery. RESULTS: The lifetime risk of surgery for POP in the general female population was 19% based on the most recent cross-sectional rates, a figure higher than the 11–12% reported from U.S. managed-care populations. CONCLUSION: There is a relatively high likelihood that a woman in Western Australia will undergo surgery for POP during her lifetime. If, as our results suggest, the burden of genital prolapse in general populations is higher than previously thought, there is justification for a stronger evidence base for prevention, early detection and intervention to reduce the personal and societal costs of these gynecological conditions. LEVEL OF EVIDENCE: II Surgery for pelvic organ prolapse is common in Western Australia, as evidenced by the 19% likelihood of surgery throughout patients' lifespans.