{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T17:13:02Z","timestamp":1792602782801,"version":"4.5.0"},"reference-count":28,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,2,3]],"date-time":"2019-02-03T00:00:00Z","timestamp":1549152000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004756","name":"Emil Aaltosen S\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004756","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003125","name":"Suomen Kulttuurirahasto","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003125","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005438","name":"H\u00e4meen Rahasto","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005438","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2019,4]]},"abstract":"Abstract<\/jats:title>Introduction<\/jats:title>The management of pelvic organ prolapse (POP<\/jats:styled-content>) varies significantly between countries. The objective of this study was to describe the methods used for POP<\/jats:styled-content> surgery in Finland and to identify the factors that affect clinicians\u2019 choice to use either a native tissue repair (NTR<\/jats:styled-content>) or a mesh repair method.<\/jats:p><\/jats:sec>Material and Methods<\/jats:title>This prospective cohort study included 3535 surgeries covering 83% of all POP<\/jats:styled-content> operations performed in Finland in 2015. The operative details and patient characteristics, including the Pelvic Floor Distress Inventory (PFDI<\/jats:styled-content>\u201020), were compared between three selected surgical methods: NTR<\/jats:styled-content>, transvaginal mesh (TVM<\/jats:styled-content>) and abdominal mesh (AM<\/jats:styled-content>). The predictive factors for the use of mesh augmentation were also studied with logistic regression analysis.<\/jats:p><\/jats:sec>Results<\/jats:title>The most common method was NTR<\/jats:styled-content> (n\u00a0=\u00a02855, 81%), followed by TVM<\/jats:styled-content> (n\u00a0=\u00a0429, 12%) and AM<\/jats:styled-content> (n\u00a0=\u00a0251, 7%). Approximately 92% of the patients who underwent primary prolapse surgery underwent NTR<\/jats:styled-content>, and mesh surgery was used mainly for recurrent prolapse. The strongest predictor of mesh surgery was previous POP<\/jats:styled-content> surgery for the same vaginal compartment (adjusted odds ratio [OR<\/jats:styled-content>]\u00a0=\u00a056, 95% confidence interval [CI<\/jats:styled-content>]\u00a0=\u00a038\u201084 for TVM<\/jats:styled-content>; adjusted OR<\/jats:styled-content>\u00a0=\u00a022, 95% CI<\/jats:styled-content>\u00a0=\u00a014\u201034 for AM<\/jats:styled-content>). Other predictive factors for mesh surgery were previous hysterectomy, healthcare district, severe bulge symptoms and advanced prolapse. TVM<\/jats:styled-content> was associated with advanced anterior prolapse and older age. AM<\/jats:styled-content> surgery was associated with advanced apical and\/or posterior compartment prolapse. PFDI<\/jats:styled-content>\u201020 scores were the highest in the AM<\/jats:styled-content> group (108 vs 103 in the TVM<\/jats:styled-content> group and 98 in the NTR<\/jats:styled-content> group, P<\/jats:italic>\u00a0=\u00a00.012), which indicates more bothersome symptoms than in the other groups.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>The Finnish practices follow international guidelines that advocate NTR<\/jats:styled-content> as the principal surgical method for POP<\/jats:styled-content>. Synthetic mesh augmentation was mainly used in patients with recurrent and advanced prolapse with severe symptoms. The variation in the rates of mesh augmentation for POP<\/jats:styled-content> surgery in different hospitals implies a lack of sufficient evidence of the most suitable treatment method and indicates a need for national guidelines.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.13520","type":"journal-article","created":{"date-parts":[[2018,12,22]],"date-time":"2018-12-22T05:10:06Z","timestamp":1545455406000},"page":"451-459","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Methods of surgery for pelvic organ prolapse in a nationwide cohort (FINPOP<\/scp> 2015)"],"prefix":"10.1111","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2304-3938","authenticated-orcid":false,"given":"Nina K.","family":"Mattsson","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Kanta\u2010H\u00e4me Central Hospital H\u00e4meenlinna Finland"},{"name":"Institute of Clinical Medicine University of Eastern Finland Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2271-1773","authenticated-orcid":false,"given":"P\u00e4ivi","family":"Karjalainen","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine University of Eastern Finland Kuopio Finland"},{"name":"Department of Obstetrics and Gynecology Central Finland Central Hospital Jyv\u00e4skyl\u00e4 Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9270-9268","authenticated-orcid":false,"given":"Anna\u2010Maija","family":"Tolppanen","sequence":"additional","affiliation":[{"name":"School of Pharmacy University of Eastern Finland Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna\u2010Mari","family":"Heikkinen","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine University of Eastern Finland Kuopio Finland"},{"name":"Terveystalo Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7452-442X","authenticated-orcid":false,"given":"Jyrki","family":"Jalkanen","sequence":"additional","affiliation":[{"name":"Central Finland Hospital District Jyv\u00e4skyl\u00e4 Finland"},{"name":"Faculty of Medicine and Life Sciences University of Tampere Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P\u00e4ivi","family":"H\u00e4rkki","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Helsinki University Hospital and Helsinki University Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kari","family":"Nieminen","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Life Sciences University of Tampere Tampere Finland"},{"name":"Department of Obstetrics and Gynecology Tampere University Hospital Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,2,3]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000286"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(97)00058-6"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2017.04.004"},{"key":"e_1_2_10_5_1","unstructured":"Finnish National Institute for Health and Welfare.Somatic special health care in Finland 2014\u20102015.http:\/\/www.julkari.fi\/bitstream\/handle\/10024\/132354\/Tr10_17.pdf?sequence=1. Accessed April 20 2017."},{"key":"e_1_2_10_6_1","volume-title":"Te Linde's Atlas of Gynecologic Surgery","author":"Cundiff GW","year":"2013"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-016-3003-y"},{"key":"e_1_2_10_8_1","first-page":"CD004014","article-title":"Surgical management of pelvic organ prolapse in women","volume":"4","author":"Maher C","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-012-1677-3"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.02.017"},{"key":"e_1_2_10_11_1","unstructured":"Food and Drug Administration (FDA).Urogynecologic surgical mesh: Update on the safety and effectiveness of transvaginal placement for pelvic organ prolapse. July 2011.https:\/\/www.fda.gov\/downloads\/medicaldevices\/safety\/alertsandnotices\/ucm262760.pdf. Accessed December 19 2018."},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dep229"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12955-017-0648-2"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0412.2011.01085.x"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.12.025"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.281053"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/SPV.0b013e31825e6707"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2017.03.048"},{"key":"e_1_2_10_19_1","first-page":"CD012079","article-title":"Transvaginal mesh or grafts compared with native tissue repair for vaginal prolapse","volume":"2","author":"Maher C","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-017-3519-9"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-016-3092-7"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-015-2734-5"},{"key":"e_1_2_10_23_1","unstructured":"Therapeutic Goods Administration (TGA) Australian Government Department of Health.TGA actions after review into urogynaecological surgical mesh implants.https:\/\/www.tga.gov.au\/alert\/tga-actions-after-review-urogynaecological-surgical-mesh-implants. Accessed December 22 2017."},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2010.03.030"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31596-3"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)32572-7"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.01.012"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-015-2757-y"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-016-3108-3"}],"container-title":["Acta Obstetricia et Gynecologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Faogs.13520","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.13520","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T04:15:18Z","timestamp":1694492118000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/aogs.13520"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2,3]]},"references-count":28,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2019,4]]}},"alternative-id":["10.1111\/aogs.13520"],"URL":"https:\/\/doi.org\/10.1111\/aogs.13520","archive":["Portico"],"relation":{},"ISSN":["0001-6349","1600-0412"],"issn-type":[{"value":"0001-6349","type":"print"},{"value":"1600-0412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,2,3]]},"assertion":[{"value":"2018-05-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-12-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-02-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}