The Effect of Age on Short-Term Outcomes After Abdominal Surgery for Pelvic Organ Prolapse

Abstract

To compare perioperative morbidity and 1-year outcomes of older and younger women undergoing surgery for pelvic organ prolapse (POP). DESIGN : Prospective ancillary analysis. SETTING : Academic medical centers in National Institutes of Health, National Institute of Child Health and Human Development Colpopexy and Urinary Reduction Study. PARTICIPANTS : Women with POP and no symptoms of stress incontinence. INTERVENTION : Abdominal sacrocolpopexy with randomization to receive Burch colposuspension for treatment of possible occult incontinence or not. MEASUREMENTS : Perioperative complications and Pelvic Organ Prolapse Quantification and quality-of-life (QOL) questionnaires (Pelvic Floor Distress Inventory, Pelvic Floor Impact Questionnaire, and Medical Outcomes Study Short-Form Health Survey (SF-36) preoperatively, immediately postoperatively, and 6 weeks and 3 and 12 months postoperatively). RESULTS : Three hundred twenty-two women aged 31 to 82 (21% aged ≥70), 93% white. Older women had higher baseline comorbidity ( P <.001) and more severe POP ( P= .003). Controlling for prolapse stage and whether Burch was performed, there were no age differences in complication rates. Older women had longer hospital stays (3.1±1.0 vs 2.7±1.5 days, P= .02) and higher prevalence of incontinence at 6 weeks (54.7% vs 37.2%, P= .005). At 3 and 12 months, there were no differences in self-reported incontinence, stress testing for incontinence, or prolapse stage. Improvements from baseline were significant on all QOL measures but with no age differences. CONCLUSION : Outcomes of prolapse surgery were comparable between older and younger women except that older women had slightly longer hospital stays.