ArticleBJOG : an international journal of obstetrics and gynaecology2024
Vaginal morphology and position associated with prolapse recurrence after vaginal surgery: A secondary analysis of the DEMAND study.
Article in BJOG : an international journal of obstetrics and gynaecology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 4 citations in OpenAlex.
- Holistic Pelvic Floor: Pelvic Floor Stress Dysfunction Diseases.International urogynecology journal · 2026Review
- Bilateral Sacrospinous Colposuspension with Sling for Advanced Pelvic Organ Prolapse: Anatomical and Functional Outcomes in a 235-Patient Cohort.Journal of clinical medicine · 2026Article
- Sexual Function and Clitoral Anatomy after Vaginal Surgery with and without Midurethral Sling.medRxiv : the preprint server for health sciences · 2026Article
- A Pilot Study of Kocher Forceps-Guided Laparoscopic Transvaginal Sacrospinous Ligament Fixation: Technique and Initial Clinical Experience.International journal of women's health · 2026Article
- The Effect of Anterior Colporrhaphy: A Prospective Study Comparing POP-Q and Upright MRI.International urogynecology journal · 2025Article
- Anterior-apical Transvaginal Mesh (Calistar-S) for Treatment of Advanced Urogenital Prolapse: Surgical and Functional Outcomes at 1 Year.International urogynecology journal · 2024Article
- The influence of the combined impairments and apical mesh surgery on the biomechanical behavior of the pelvic floor system.Frontiers in bioengineering and biotechnology · 2023Article
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Authors and funding
13 authors at 9 institutions in 1 country.
Funding
Abstract
objectiveTo identify vaginal morphology and position factors associated with prolapse recurrence following vaginal surgery.
designSecondary analysis of magnetic resonance images (MRI) of the Defining Mechanisms of Anterior Vaginal Wall Descent cross-sectional study.
settingEight clinical sites in the US Pelvic Floor Disorders Network. POPULATION OR SAMPLE: Women who underwent vaginal mesh hysteropexy (hysteropexy) with sacrospinous fixation or vaginal hysterectomy with uterosacral ligament suspension (hysterectomy) for uterovaginal prolapse between April 2013 and February 2015.
methodsThe MRI (rest, strain) obtained 30-42 months after surgery, or earlier for participants with recurrence who desired reoperation before 30 months, were analysed. MRI-based prolapse recurrence was defined as prolapse beyond the hymen at strain on MRI. Vaginal segmentations (at rest) were used to create three-dimensional models placed in a morphometry algorithm to quantify and compare vaginal morphology (angulation, dimensions) and position.
main outcome measuresVaginal angulation (upper, lower and upper-lower vaginal angles in the sagittal and coronal plane), dimensions (length, maximum transverse width, surface area, volume) and position (apex, mid-vagina) at rest.
resultsOf the 82 women analysed, 12/41 (29%) in the hysteropexy group and 22/41 (54%) in the hysterectomy group had prolapse recurrence. After hysteropexy, women with recurrence had a more laterally deviated upper vagina (p = 0.02) at rest than women with successful surgery. After hysterectomy, women with recurrence had a more inferiorly (lower) positioned vaginal apex (p = 0.01) and mid-vagina (p = 0.01) at rest than women with successful surgery.
conclusionsVaginal angulation and position were associated with prolapse recurrence and suggestive of vaginal support mechanisms related to surgical technique and potential unaddressed anatomical defects. Future prospective studies in women before and after prolapse surgery may distinguish these two factors.
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