Risk factors associated with pelvic floor disorders in women undergoing surgical repair.

OBJECTIVE: To identify demographic, obstetric, and gynecologic risk factors associated with the development of pelvic floor disorders in women who undergo surgical correction.

METHODS: We conducted a case-control study, with cases selected from all women who had surgery by our urogynecology service from July 1, 1999 to July 1, 2000 and who had a first obstetric delivery at Magee Womens Hospital (n = 80). Controls were patients seen in the general gynecology office over the same time period who had no complaints associated with pelvic floor disorders in the previous 3 years, less than stage I prolapse on pelvic examination, and first obstetric delivery at Magee Womens Hospital (n = 176). Demographic, obstetric, and gynecologic variables were compared between cases and controls.

RESULTS: There were no significant differences in race, current age, gravidity, or parity. Cases were more likely than controls to have a higher body mass index (BMI) (28.6 +/- 6.3 versus 26.4 +/- 6.1 kg/m(2), P =.01), to be younger at first delivery (25.8 +/- 5.3 versus 28.4 +/- 4.9 years, P <.001), to have undergone a forceps delivery (64% versus 44%, P < orr =.001), and to have had previous gynecologic surgery (34% versus 16%, P =.003). Using logistic regression modeling, all of these factors were found to be independently associated with pelvic floor disorders. After menopause, use of hormone replacement therapy 5 or more years was protective (P =.001).

CONCLUSION: In our surgical patients, younger age at first delivery, higher BMI, forceps delivery, and history of gynecologic surgery were significantly associated with subsequent development of pelvic floor disorders.