Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence
Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence
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DOI：
10.1016/s0029-7844(97)00058-6
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发表时间：
1997-04-01
影响因子：
7.2
通讯作者：
Clark, AL
中科院分区：
文献类型：
--
作者：
Olsen, AL;Smith, VJ;Clark, AL
目的：确定以人群为基础的队列中手术治疗盆腔器官脱垂和尿失禁的发生率，并描述其临床特征。方法：回顾性队列研究纳入1995年期间所有因脱垂和尿失禁接受手术治疗的患者；所有人都是西北永久募捐组织的成员，该组织包括149554名20岁及以上的女性。使用标准化数据收集表来审查确定的395名妇女的所有住院和门诊图表。检查的变量包括年龄、种族、身高、体重、阴道产次、吸烟史、病史和手术史，包括术前评估、所做的手术和所有先前手术的细节。分析包括计算年龄特异性和累积发生率，并确定与脱垂或尿失禁进行的重复手术相比，首次手术的次数。结果：随着年龄的增长，发病率呈上升趋势。80岁前因脱垂或尿失禁而接受单次手术的终生风险为11.1%。大多数患者年龄较大，绝经后，生育和超重。近一半的人现在或曾经吸烟，五分之一的人患有慢性肺病。再手术是常见的（29.2%的病例），重复手术的时间间隔随着每次连续修复而缩短。结论：盆底功能障碍是老年妇女的主要健康问题，因盆腔器官脱垂和尿失禁而接受单次手术的终生风险为11.1%，并且再次手术的比例很大。我们的结果需要进一步的流行病学研究，以确定这些疾病的病因、自然病史和长期治疗结果。(C) 1997年由美国妇产科医师学会出版。
Objective: To determine the incidence of surgically managed pelvic organ prolapse and urinary incontinence in a population-based cohort, and to describe their clinical characteristics.Methods: Our retrospective cohort study included all patients undergoing surgical treatment for prolapse and incontinence during 1995; all were members of Raiser Permanente Northwest, which included 149,554 women age 20 or older. A standardized data-collection form was used to review all inpatient and outpatient charts of the 395 women identified. Variables examined included age, ethnicity, height, weight, vaginal parity, smoking history, medical history, and surgical history, including the preoperative evaluation, procedure performed, and details of all prior procedures. Analysis included calculation of age-specific and cumulative incidences and determination of the number of primary operations compared with repeat operations performed for prolapse or incontinence.Results: The age-specific incidence increased with advancing age. The lifetime risk of undergoing a single operation for prolapse or incontinence by age 80 was 11.1%. Most patients were older, postmenopausal, parous, and overweight. Nearly half were current or former smokers and one-fifth had chronic lung disease. Reoperation was common (29.2% of cases), and the time intervals between repeat procedures decreased with each successive repair.Conclusion: Pelvic floor dysfunction is a major health issue for older women, as shown by the 11.1% Lifetime risk of undergoing a single operation for pelvic organ prolapse and urinary incontinence, as well as the large proportion of reoperations. Our results warrant further epidemiologic research in order to determine the etiology, natural history, and long-term treatment outcomes of these conditions. (C) 1997 by The American lege of Obstetricians and Gynecologists.