Evidence map›Paper›PMID 42867516›Full record

ReviewInternational urogynecology journal2026

Risk Factors for Recurrence Following Surgery for Apical Prolapse: A Systematic Review and Meta-Analysis.

Agustina Vendramini, Ann-Sophie Page, Vinita Gottipati, Carolyn W Swenson, Ka Lai Shek, Marie E Sullivan, Kirsten Kluivers, Ankita Gupta, John O L DeLancey, Mackenzie Wood and 3 more

Abstract readReview
PubMed Publisher
In one paragraph

Review in International urogynecology journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Agustina VendraminiHospital Donación Francisco Santojanni and Hospital Naval dr. Pedro Mallo, Ciudad Autónoma de Buenos Aires, Argentina. vendramini.agus@gmail.com.ORCID http://orcid.org/0000-0002-9109-7332
Ann-Sophie PageDepartment of Obstetrics & Gynecology, University Hospitals Leuven, Leuven, Belgium.ORCID http://orcid.org/0000-0002-1827-0020
Vinita GottipatiAlbany Medical Center, Albany, NY, 12204, USA.ORCID http://orcid.org/0000-0002-2538-6689
Carolyn W SwensonUniversity of Utah, Salt Lake City, Utah, USA.ORCID http://orcid.org/0009-0008-7717-673X
Ka Lai ShekWestern Sydney University, Sydney, Australia.ORCID http://orcid.org/0000-0001-6836-4474
Marie E SullivanWake Forest University, Winston Salem, NC, 27103, USA.ORCID http://orcid.org/0000-0002-2847-5249
Kirsten KluiversRadboud University Medical Center, Nijmegen, the Netherlands.ORCID http://orcid.org/0000-0002-4681-4304
Ankita GuptaDivision of Urogynecology and Pelvic Reconstructive Surgery, University of Louisville Health, 530 S Jackson Street, Louisville, KY, 40202, USA.ORCID http://orcid.org/0000-0001-7159-5695
John O L DeLanceyDepartment of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA.ORCID https://orcid.org/0000-0002-1012-7713
Mackenzie WoodDepartment of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, NC, USA.ORCID http://orcid.org/0009-0005-4788-029X
Kaidi KangDepartment of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, NC, USA.ORCID http://orcid.org/0000-0003-0922-5727
Catherine A MatthewsDepartment of Urology, Wake Forest University School of Medicine, Winston-Salem, NC, USA.ORCID https://orcid.org/0009-0006-2237-6094
Cara L GrimesAlbany Medical Center, Albany, NY, 12204, USA.ORCID http://orcid.org/0000-0001-5927-1663

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introduction and hypothesisMost of the existing literature focuses on patient-level risk factors for recurrence after prolapse surgery in general, rather than specifically for uterovaginal prolapse (U-POP). As uterine-preserving procedures are increasingly performed, understanding patient-level risk factors for recurrence after U-POP is essential.

methodsFollowing Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched for studies including women undergoing U-POP surgery to evaluate risk factors for recurrence. Risk of bias was assessed using the Grading of Recommendations Assessment, Development and Evaluation framework. Odds ratios were pooled using random-effects meta-analysis. Findings informed a Delphi process at the Global Consensus Conference on Controversies in Surgical Management of Primary U-POP (April 2026) resulting in consensus statements (≥80% agreement threshold).

resultsOf the 4,149 abstracts screened, 25 studies (14,860 women; median follow-up 24 months) met the eligibility criteria. Meta-analyses were performed for 9 of the 16 risk factors identified. Advanced preoperative prolapse stage (OR 2.75; 95% CI 1.39-5.46), prior prolapse surgery (OR 2.09; 95% CI 1.16-3.75), and higher body mass index (BMI; OR 1.10 per unit increase; 95% CI 1.06-1.15) were each significantly associated with an increased risk of recurrence. No significant associations were identified for age, diabetes, smoking, parity, menopause, or preoperative estrogen use. Where there were insufficient data, expert consensus identified levator ani avulsion, enlarged genital hiatus, and connective-tissue disorders as additional risk factors.

conclusionsAdvanced preoperative prolapse stage, prior prolapse surgery, and higher BMI were each significantly associated with U-POP recurrence. Together with expert consensus, these findings should inform preoperative counseling and individualized surgical planning to improve long-term outcomes.

Indexed as

Consensus statementMeta-analysisPelvic organ prolapseRisk factorsSurgical recurrence

Identifiers

PMID42867516

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.