Risk factors for pelvic organ prolapse in women after hysterectomy

Aim. To identify risk factors for the development of pelvic organ prolapse (POP) in women after hysterectomy.

Materials and methods. The study included 200 patients who presented for a scheduled follow-up examination 6 months after hysterectomy. The main group consisted of 100 patients who developed POP within 6 months after surgery, while the control group included patients without POP following the procedure. The diagnosis of POP was established based gynecological examination, and its severity was assessed using the international Pelvic Organ Prolapse Quantification (POP-Q) system. Inclusion criterion: hysterectomy performed six months prior to the study. Exclusion criteria: presence of oncopathology and refusal to participate (refusal to sign informed consent to participate in the study).

Results. According to POP-Q system, stage I POP was detected in 47 % of women, stage II in 34 %, and stage III in 19 %. Patients with POP were significantly more likely to be aged ≥54 years (55 % vs. 11 %, p <0.05), have a history of obstetric trauma (47 % vs. 12 %, p <0.05), and report regular heavy lifting (35 % vs. 9 %, p <0.05). Anthropometric parameters (height, weight, body mass index) and the prevalence of somatic pathology (diabetes mellitus, arterial hypertension, chronic obstructive pulmonary disease, connective tissue dysplasia, chronic constipation) did not significantly differ between groups (p >0.05).

Conclusion. Age over 54 years, obstetric trauma, and a lifestyle associated with regular heavy lifting are key predictors of POP after hysterectomy. These factors exert a cumulative negative effect on the pelvic support structures, predisposing to functional insufficiency and organ descent. Identification of these risk factors during the preoperative evaluation enables the formation of high-risk groups, development of individualized preventive strategies, and optimization of surgical approaches to reduce the likelihood of recurrence.

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