Apical Support During Hysterectomy for Pelvic Organ Prolapse

The prevalence of pelvic organ prolapse (POP) in the United States is estimated to be between
40-50% with an anticipated increase over the next several decades. Approximately 300,000
women undergo surgeries to repair POP in the United States every year. Following pelvic
reconstructive surgery, recurrence rates of symptomatic prolapse range between 6-30%. Our
understanding of pelvic anatomy and its support has been significantly improved over recent
decades, with many researchers reporting on details and mechanics previously not understood.

In November 2017, the American College of Obstetricians and Gynecologists released a new
practice bulletin outlining the current standard of care for the treatment of women with
pelvic organ prolapse. In this bulletin, they state that a hysterectomy alone is not adequate
treatment for pelvic organ prolapse, and further that any woman having a hysterectomy for
pelvic organ prolapse should undergo a concurrent apical suspension procedure as a standard
of care.

The purpose of this study is to determine the proportion of patients already meeting the
recently recommended best practice of supporting the vaginal apex at the time of hysterectomy
for pelvic organ prolapse among the population who underwent the surgery performed at a
TriHealth facility between October 2012 and October 2017.

Inclusion Criteria:

- Adults 18 years of age or older

- Underwent hysterectomy for pelvic organ prolapse, performed at a TriHealth facility
between October 2012 and October 2017

Exclusion Criteria:

- Age < 18 years old

- Pelvic Organ Prolapse was not an indication for their surgery

- Surgery performed by a physician of Cincinnati Urogynecology Associates.