Uterine preserving procedures for treatment of pelvic organ prolapse (POP) have been drawing increased interest in recent years. The aim of this study was to investigate the impact of obesity on outcomes following uterine preserving apical prolapse repair.
We performed a retrospective cohort study including women who underwent uterine-preserving apical prolapse repair between 2010 and 2024. The cohort was categorized into two groups based on body mass index (BMI): BMI ≤ 30 and BMI > 30. Outcome measures included subjective, anatomical, and composite outcomes as well as patient satisfaction.
A total of 376 women were included; 316 (84.0%) with BMI ≤ 30 and 60 (16.0%) with BMI > 30. Mean BMI was 24.6 ± 2.6 in the non-obese group vs. 33.2 ± 3.5 in the obese group. Postoperative complications within 30 days after surgery were similar between groups (12.0% vs. 16.7%, p = 0.323, for the BMI ≤ 30 and > 30 groups, respectively). Subjective success rates were 89.5% vs. 90.6% (p = 0.811), and composite outcome success was 88.1% vs. 81.1% (p = 0.168) for the BMI ≤ 30 and > 30 groups, respectively. Anatomical success was significantly lower in the BMI > 30 group (81.1% vs. 94.0%, p = 0.004). On multivariate logistic regression, BMI > 30 and increased preoperative POP-Q Bp point were independently associated with increased risk of anatomical failure.
Obesity was not associated with increased postoperative complications 30 days after surgery following uterine-preserving apical prolapse repair. However, anatomical success was significantly lower among women with BMI > 30. These findings should be interpreted cautiously given the unequal group sizes and heterogeneity of the cohort.
European journal of obstetrics, gynecology, and reproductive biology. 2026 Apr 05 [Epub ahead of print]
Adiel Cohen, Yarden Dalyahu, Tal Zilberman, Gilad Karavani, Efrat Shekel, David Shveiky, Henry H Chill
Department of Obstetrics and Gynecology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel. Electronic address: ., Hebrew University Medical School, Jerusalem, Israel., Department of Obstetrics and Gynecology, Tzafon Medical Center, Poriya, Israel; Azriely Faculty of Medicine, Bar-Ilan University, Safed, Israel., Department of Obstetrics and Gynecology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel., Department of Obstetrics and Gynecology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel; Division of Urogynecology, Department of Obstetrics and Gynecology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.