Histerektomi Sonrasi Vajinal Kuff Prolapsusu İçin Risk Faktörlerinin Analizi

Amaç: Histerektomi sonrası vajinal kuff prolapsusu için risk faktörlerini belirlemek ve histerektomi sonrası kuff prolapsusu sıklığını tahmin etmek Materyal ve Metod: Bu çalışma, Ocak 2010 ve Aralık 2012 yılları arasında benign sebeplerden dolayı histerektomi yapılan kadınlardan oluşan retrospektif bir çalışmadır. Medikal kayıtlar iki grup hastadan toplanmıştır. Vaka grubu, vajinal kuff prolapsusu için cerrahi uygulanan kadınlar iken kontrol grubu çalışma süresince yapılan histerektomi sonrasında vajinal kuff prolapsusu tesbit edilmeyen kadınlar idi. Çoklu regresyon modeli uygulanarak histerektomi sonrası risk faktörleri tanımlandı. Bulgular: 1758 histerektominin 56 (3.19%) tanesi vaka grubu idi. Çoklu regresyon analizi histerektomi sırasında yaşın ≥60 olmasını, astım, eski pelvik organ prolapsusu cerrahisi varlığını, vajinal yoldan histerektomi yapılmasını, genital prolapsus nedeni ile histerektomi yapılmasını, vücut kitle indeksinin ≥27 kg/m2 ve vajinal doğum sayısının ≥2 olmasını histerektomi sonrası vajinal kuff prolapsusu gelişimi için risk faktörleri olduğunu gözterdi. Araştırma Makalesi / Research Article 63 Kokanalı et al. Cukurova Medical Journal Sonuç: Histerektomi sonrası kuff prolapsusu nadir bir komplikasyondur. İleri yaş, obesite, kronik akciğer hastalığı, önceki genital prolapse cerrahisi, vajinal histerektomi, 2 ve üstü vajinal doğum varlığı kuff prolapsusu riskini arttırmaktadır. Bu risk faktörleri tanımlamak bu komplikasyonu önlemede önemlidir.

Anahtar Kelimeler:

Histeerktomi, risk faktörleri, vajinal kuff prolapsusu

Analysis of Risk Factors for Post-Hysterectomy Vaginal Vault Prolapse

Purpose: To identify risk factors for vaginal vault prolapse after hysterectomy and also estimate incidence of posthysterectomy vault prolapse. Material and Methods: This is a retrospective study of women who underwent hysterectomy for benign indications between January 2010 and December 2012. Medical records were reviewed from two groups of women. Case group was women who had undergone surgery for vault prolapse after hysterectomy; control group was women who were not identified with vault prolapse after hysterectomy by the time of the study. Multivariate regression model identified odds of post-hysterectomy vault prolapse. Results: Of 1758 hysterctomies, 56 (3.19%) were cases. Multivariate regression analysis demonstrated that age at hysterectomy ≥60 years, presence of asthma, previous pelvic organ prolapse surgery, vaginal route of hysterectomy, genital prolapse as indication of hysterectomy, body mass index ≥27 kg/m2 and number of vaginal delivery ≥2 are independent risk factors for development of post-hysterectomy vault prolapse. Conclusions: Vault prolapse after hysterectomy is a relatively rare complication. Elderly age, obesity, chronic obstructive lung diseases, prior genital prolapse sugery, vaginal hysterectomy, genital prolapse as indication of hysterectomy and the number of vaginal delivery ≥2 increase vault prolapse risk. Identification of these risk factors is important to prevent this complication.

Keywords:

Hysterectomy, risk factors, vaginal vault prolapse,

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