FACTORES DE RIESGO ASOCIADOS A PROLAPSO DE CÚPULA VAGINAL, EN PACIENTES SOMETIDAS A HISTERECTOMÍA VAGINAL Y ABDOMINAL, QUE ACUDEN A LA CONSULTA EXTERNA DEL HOSPITAL GENERAL PROVINCIAL PABLO ARTURO SUÁREZ, EN EL PERIODO 2013 A 2018

Marcia del Carmen Mejia Auquilla

doi:10.16921/reflexiones.v21i2.116

Marcia del Carmen Mejia Auquilla Hospital Eugenio Espejo

DOI: https://doi.org/10.16921/reflexiones.v21i2.116

Keywords: myomatosis, hysterectomy, uterine leiomioma, Prolapso, Prolapso Uterino, Prolapso de Órgano Pélvico, Histerectomía vaginal, Prevalencia, Factores de Riesgo

Abstract

Introduction: Hysterectomy is one of the most common surgical procedure in Gynecology and Obstetrics, but, this procedure has a risk of many complications such as vaginal vault prolapse, that is the most common late complication in this patients. Aim: To identify the clinical, surgical, and epidemiological risk factors in patients with the diagnosis of vaginal vault prolapse that had been operated for vaginal or abdominal hysterectomy and had been treated in ambulatory settings at Pablo Arturo Suárez General Hospital, between 2013 to 2018. Materials and Methods: Cross-sectional, analytical, and retrospective study has been designed. A total of 869 patients operated for an abdominal and vaginal hysterectomy since 2013 were included. Qualitative variables were analyzed with absolute and relative frequencies, and, quantitative variables were analyzed with dispersion and central tendency measures. Pearson's Chi-Square test had been applied to determine the association between categorical variables. A binary logistic model had been designed to describe risk factor related to vaginal vault prolapse, that had been expressed by odds ratios (OR) and confidence intervals. SPSS Statistics Software had been used for statistical analysis. A p-value < 0.05 was considered to determine statistical significance. Results: Prevalence of vaginal vault prolapse was 5.2% (n=45). There were significant differences in age, and educational level, between patients with vaginal vault prolapse and type of hysterectomy. Patients with a background of vaginal hysterectomy developed vaginal vault prolapse more frequently than patients with a background of abdominal hysterectomy (16.8% versus 2.2%). We demonstrated that vaginal hysterectomy is an associated risk factor for early vaginal vault prolapse OR: 8.367 (IC95%: 4.587 – 15.261, p=0.001), so, factors such as obesity OR: 3.281 (CI95%: 1.842 – 5.843, p=0.001), uterine myomatosis OR: 9.576 (IC95%: 5.261 – 17.428, p=0.001) and previous genital prolapse OR: 7.894 (IC95%: 3.791 – 16.439, p=0.001), were precipitating factors for vaginal vault prolapse. Conclusions: Patients with a background of vaginal hysterectomy had more prevalence of vaginal vault prolapse than patients with abdominal hysterectomy. Obesity, uterine myomatosis, and previous genital prolapse were precipitating factors for this complication.

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RISK FACTORS ASSOCIATED WITH VAGINAL DOME PROLAPSE, IN PATIENTS UNDERGOING VAGINAL AND ABDOMINAL HYSTERECTOMY, WHO ATTEND THE OUTPATIENT CLINIC OF THE PABLO ARTURO SUÁREZ PROVINCIAL GENERAL HOSPITAL, IN THE PERIOD 2013 TO 2018

Abstract

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