Appendix 1. Participant Characteristics Between Those With and Without Recurrent Prolapse as Defined Using a Composite Definition

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Jelovsek JE, Chagin K, Lukacz ES, Nolen TL, Shepher JP, Barber MD, et al. Models for predicting recurrence, complications, and health status in women after pelvic organ prolapse surgery. Obstet Gynecol 2018; 132.

The authors provided this information as a supplement to their article.

Appendix 1. Participant Characteristics Between Those With and Without Recurrent Prolapse as Defined Using a Composite Definition

Recurrence =

209 (20%)

No Recurrence

= 850 (80%)

Variables N (%) or

Mean (SD)

N (%) or Mean (SD)

N (%) or Mean

(SD) p-value Study

CARE 278 (26%) 20 (10%) 258 (30%) <0.001

COLPO 94 (9%) 13 (6%) 81 (10%)

OPTIMAL 299 (28%) 72 (35%) 227 (27 %) OPUS 388 (37 %) 104 (50%) 284 (33%)

Age, years 62.8 (11.2) 62.2 (10.6) 62.9 (11.3) 0.449

Race

African American 63 (6%) 9 (4%) 54 (6%) 0.189

Caucasian 945 (89%) 186 (89%) 759 (89%)

Other 50 (5%) 14 (7%) 36 (4%)

Missing 1 (0%)

Vaginal Parity 2.9 (1.8) 3.5 (2.3) 2.9 (1.6) <0.001

Missing 99 (10%)

BMI, kg/m² 28 (5.2) 28.5 (5.3) 27.9 (5.2) 0.144

Missing 7 (1%) Prior Hysterectomy

Yes 481 (46 %) 79 (38%) 402 (47%) 0.014 No 574 (54 %) 129 (62%) 445 (53%)

Missing 4 (0%) Estrogen Therapy

Yes 358 (34%) 64 (33%) 294(38%) 0.152

No 603 (57%) 131 (67%) 472 (62%) Missing 98 (10%)

Tissue Disorders

Yes 14 (1%) 4 (2%) 10 (1%) 0.397

No 1030 (97%) 201 (98%) 829 (99%) Missing 15 (1%)

Cardiac Disorders

Yes 193 (18%) 29 (14%) 164 (19%) 0.072 No 859 (81 %) 178 (86%) 681 (81%)

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Missing 7 (1%) Vascular Disorders

Yes 434 (41%) 85 (41 %) 349 (42 %) 0.879 No 611 (58 %) 122 (59 %) 489 (58 %)

Missing 14 (1%) Number of Comorbid

Conditions 2.5 (1.7) 2.5 (1.8) 2.5 (1.7) 0.719

Missing 4 (0%) Prior incontinence surgery

Yes 56 (5%) 12 (6%) 44 (5%) 0.741

No 999 (95%) 196 (94%) 803 (95%) Missing 4 (0%)

Prior surgery for prolapse repair

Yes 205 (19%) 30 (14%) 175 (21%) 0.042 No 850 (81%) 178 (86%) 672 (79 %)

Missing 4 (0%) POPQ

II 253 (24%) 36 (17%) 217 (26 %) 0.028 III 669 (63%) 138 (67%) 531 (63%)

IV 130 (12 %) 32 (16%) 98 (12%) Missing 7 (1%)

POPQ Ba 2.8 (2.5) 3.4 (2.6) 2.7 (2.5) <0.001

Missing 2 (0%)

POPQ C 0.3 (4.4) 0.9 (4.5) 0.1 (4.3) 0.018

Missing 4 (0%)

POPQ BP 0.3 (3.2) 0.5 (3.4) 0.3 (3.2) 0.499

Missing 3 (0%)

POPQ GH 5.0 (1.5) 5.2 (1.5) 4.9 (1.5) 0.011

Missing 13 (1%) Anterior repair

Yes 493 (47 %) 107 (51 %) 386 (45%) 0.133 No 566 (53 %) 102 (49%) 464 (55%)

Posterior repair

Yes 412 (39%) 76 (36 %) 336 (40%) 0.400

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No 647 (61%) 133 (64%) 514 (60%) Missing 0 (0%)

Continence Procedure

Burch 133 (13%) 10 (5%) 123 (15%) <0.001 Sling/TVT 524 (49 %) 128 (61%) 396 (47%)

Other 10 (1%) 3 (1%) 7 (1%)

None 392 (37%) 68 (33%) 324 (38%) Concurrent hysterectomy or

oophorectomy

Yes 581 (55%) 124 (59%) 457 (54 %) 0.147 No 478 (45 %) 85 (41%) 393 (46%)

Anesthetic

General 996 (94%) 198 (95%) 798 (94%) 0.543

Regional 60 (6%) 10 (5%) 50 (6%)

Missing 3 (0%) Heavy Lifting Frequency

Never 371 (35 %) 67 (36%) 304 (40%) 0.114 1 per week 100 (9%) 19 (10%) 81 (11%)

Greater Than 1 per Week 203 (19%) 38 (20%) 165 (22 %) Less Than 1 per Month 19 (2%) 1 (1%) 18 (2%)

1 per Month 103(10 %) 29 (16%) 74 (10%) 2 or 3 per Month 143 (14%) 32 (18%) 110 (15%)

Missing 120 (11%) SF-36 Question 3

Limited a little 370 (35%) 69 (35%) 301 (37%) 0.866 Limited a lot 457 (43 %) 92 (47%) 365 (45%)

Not limited at all 175 (17 %) 34 (17%) 141 (18 %) Missing 57 (5%)

Strenuous Exercise

(Days/week) 1.2 (1.7) 1.1 (1.7) 1.2 (1.7) 0.866

Missing 123 (12%) Any Strenuous Physical

Activity

Yes 658 (62%) 137 (73 %) 521 (69%) 0.287 No 281 (27%) 50 (27 %) 231 (31%)

Missing 120 (11 %)

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Smoking Status

Current 66 (6%) 13 (6%) 53 (6%) 0.424

Never 646 (62%) 135 (65 %) 511 (61%) Former 339 (31%) 59 (29%) 280 (33%) Missing 8 (1%)

Lower GI Diagnosis

Yes 158 (15%) 25 (12%) 133 (16%) 0.163 No 887 (84%) 183 (88%) 704 (84%)

Missing 14 (1%) Upper GI Diagnosis

Yes 235 (22%) 35 (17%) 200 (24%) 0.030 No 807 (76%) 172 (83%) 635 (76%)

Missing 17 (2%) Use of anticoagulants

Yes 48 (5%) 7 (3%) 41 (5%) 0.359

No 1011 (95%) 202 (97%) 809 (95%) Missing 0 (0%)

Vault suspension repair type ¶

Abdominal 278 (26%) 20 (10%) 258 (30 %) <0.001 Colpocleisis 120 (12%) 16 (8%) 104 (12%)

SSLS 198 (18.7%) 54 (25.8%) 114 (16.9%) USLS 410 (38.7%) 110 (52.6%) 300 (35.3%)

Other 15 (1.4%) 2 (1%) 13(1.5%)

None 38 (4%) 7 (3%) 31 (4%)

Pelvic Organ Prolapse Quantification (POPQ) SSLS = sacrospinous ligament suspension USLS = uterosacral ligament suspension

CARE = Colpopexy and Urinary Reduction Efforts trial

OPUS = Outcomes Following Vaginal Prolapse Repair and Midurethral Sling trial OPTIMAL = Operations and Pelvic Muscle Training in the Management of Apical Support Loss trial

¶ One participant received a uterosacral ligament suspension and sacrospinous ligament suspension and was classified as receiving a uterosacral ligament suspension for this analysis

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P-value was calculated with chi-square tests for categorical variables and t-Test for continuous variables

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Appendix 2. Participant Characteristics Between Those With and Without at Least one Serious Adverse Event

SAE = 222

(17%)

No SAE = 1079

(83%)

Variables N (%) or Mean

(SD)

N (%) or Mean (SD)

N (%) or Mean

(SD) p-value

Study

CARE 322 (25%) 83 (37%) 239 (22%) <0.001

COLPO 147 (11%) 23 (10%) 124 (11%)

OPTIMAL 372 (29%) 50 (23%) 322 (30%)

OPUS 460 (35%) 66 (30%) 394 (37%)

Age, years 62.8 (11.6) 64.2 (11.3) 62.5 (11.7) 0.061

Missing 1 (0%)

Race

Caucasian 1,151 (89%) 197 (89%) 954 (88%)

Other 69 (5%) 8 (4%) 61 (6%)

Missing 2 (0%)

Parity 3.0 (1.7) 2.9 (1.6) 3 (1.8) 0.627

Missing 154 (12%)

BMI, kg/m² 28.0 (5.2) 28.1 (5.6) 27.9 (5.1) 0.698

Missing 8 (0%)

Prior Hysterectomy

Yes 583 (45%) 115 (52%) 468 (44%) 0.026

No 712 (55%) 107 (48%) 605 (56%)

Missing 6 (0%)

Estrogen Therapy

Yes 419 (32%) 68 (34%) 351 (37%) 0.453

No 729 (56%) 131 (66%) 598 (63%)

Missing 153 (12%)

Tissue Disorders

Yes 15 (1%) 4 (2%) 11 (1%) 0.3327

No 1265 (97%) 217 (98%) 1048 (99%)

Missing 21 (2%)

Cardiac Disorders

Yes 242 (19%) 51 (23%) 191 (18%) 0.065

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No 1048 (80%) 169 (77%) 879 (82%)

Missing 11 (1%)

Vascular Disorders

Yes 526 (40%) 93 (43%) 433 (41%) 0.591

No 756 (58%) 125 (57%) 631 (59%)

Missing 19 (1%)

Number of Comorbid

Conditions 2.5 (1.8) 2.6 (1.9) 2.5 (1.7) 0.221

Missing 6 (0%)

Prior incontinence surgery

Yes 67 (5%) 12 (5%) 55 (5%) 0.864

No 1228 (95%) 210 (95%) 1018 (95%)

Missing 6 (0%)

Prior surgery for prolapse

repair

Yes 242 (19%) 49 (22%) 193 (18%) 0.155

No 1053 (81%) 173 (78%) 880 (82%)

Missing 6 (0%)

POPQ

II 322 (25%) 41 (19%) 281 (26%) 0.05

III 807 (62%) 147 (67%) 660 (62%)

IV 160 (12%) 32 (14%) 128 (12%)

Missing 12 (1%)

POPQ Ba 2.8 (2.6) 3.1 (2.5) 2.8 (2.6) 0.06

Missing 2 (0%)

POPQ C 0.3 (4.4) 1.0 (4.4) 0.1 (4.4) 0.012

Missing 5 (0%)

POPQ BP 0.4 (3.3) 0.6 (3.3) 0.3 (3.3) 0.170

Missing 4 (0%)

POPQ GH 5.0 (1.5) 5.1 (1.6) 4.9 (1.5) 0.121

Missing 22 (2%)

Anterior repair

Yes 593 (46%) 90 (40%) 503 (47%) 0.098

No 708 (54%) 132 (60%) 576 (53%)

Posterior repair

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Yes 498 (38%) 74 (33%) 424 (39%) 0.096

No 803 (62%) 148 (67%) 655 (61%)

Burch 154 (12%) 36 (16%) 118 (11%) 0.012

Sling/TVT 648 (50%) 94 (42%) 554 (51%)

Other 14 (1%) 5 (2%) 9 (1%)

None 485 (37%) 87 (39%) 398 (37%)

Concurrent hysterectomy

or oophorectomy

Yes 696 (54%) 107 (48%) 589 (55%) 0.082

No 605 (46%) 115 (52%) 490 (45%)

Anesthetic

General 1211 (93%) 204 (92%) 1007 (94%) 0.518

Regional 87 (7%) 17 (8%) 70 (6%)

Missing 3 (0%)

Heavy Lifting Frequency

Never 437 (34%) 83 (42%) 354 (38%) 0.938

1 per Week 113 (9%) 19 (10%) 94 (10%)

Greater Than 1 per Week 246 (19%) 39 (20%) 207 (22%)

Less Than 1 per Month 21(2%) 4(2%) 17(2%)

1 per Month 126(10%) 21(11%) 105(11%)

2 or 3 per Month 173 (13%) 30 (15%) 143 (15%)

Missing 185 (14%)

SF-36 Question 3

Limited a little 456 (35%) 79 (37%) 377 (37%) 0.44

Limited a lot 560 (43%) 105 (49%) 455 (45%)

Not limited at all 209 (16%) 31 (14%) 178 (18%)

Missing 76 (6%)

Strenuous 1.2 (1.7) 1.0 (1.7) 1.2 (1.7) 0.108

Missing 187 (14%)

Activity

Yes 787 (60%) 132 (67%) 655 (71%) 0.283

No 329 (25%) 64 (33%) 265 (29%)

Missing 185 (14%)

Smoking Status

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Current 86 (7%) 18 (8%) 68 (6%) 0.221

Never 788 (61%) 122 (56%) 666 (62%)

Former 413 (32%) 77 (35%) 336 (31%)

Missing 14 (1%)

Lower GI Diagnosis

Yes 195 (15%) 27 (12%) 168 (16%) 0.189

No 1085 (83%) 192 (88%) 893 (84%)

Missing 21 (2%)

Upper GI Diagnosis

Yes 290 (22%) 54 (25%) 236 (22%) 0.445

No 988 (76%) 165 (75%) 823 (78%)

Missing 23 (2%)

Use of anticoagulants

Yes 67 (5%) 14 (6%) 53 (5%) 0.392

No 1234 (95%) 208 (94%) 1026 (95%)

Vault suspension repair

type ¶

Abdominal 322 (25%) 83 (37%) 239 (22%) <0.001

Colpocleisis 184 (14%) 31 (14%) 153 (14%)

SSLS 240 (18%) 35 (16%) 205 (19%)

USLS 489 (38%) 64 (29%) 425 (39%)

Other 20 (2%) 5 (2%) 15 (1%)

None 46 (4%) 4 (2%) 42 (4%)

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Appendix 3. Participant Characteristics Between Those With and Without at Least one Dindo Grade III or IV Complication

Dindo Grade III or IV = 147

(11%)

No Dindo Grade III or IV= 1154 (89%)

Variables N (%) or Mean

(SD)

Mean (SD) or n (%)

Mean (SD) or n

(%) p-value

Study

CARE 322 (25%) 53 (36%) 269 (23%) <0.001

COLPO 147 (11%) 16 (11%) 131 (12%)

OPTIMAL 372 (29%) 24 (16%) 348 (30%)

OPUS 460 (35%) 54 (37%) 406 (35%)

Age, years 62.8 (11.6) 63.8 (11.0) 62.7 (11.7) 0.298

Missing 1 (0%)

Race

Caucasian 1,151 (89%) 132 (90%) 1019 (88%)

Other 69 (5%) 6 (4%) 63 (6%)

Missing 2 (0%)

Parity 3.0 (1.7) 2.9 (1.6) 3.0 (1.7) 0.711

Missing 154 (12%)

BMI, kg/m² 28.0 (5.2) 28.0 (5.7) 28.0 (5.2) 0.894

Missing 8 (0%)

Prior Hysterectomy

Yes 583 (45%) 75 (51%) 508 (44%) 0.121

No 712 (55%) 72 (49%) 640 (56%)

Missing 6 (0%)

Estrogen Therapy

Yes 419 (32%) 46 (35%) 373 (37%) 0.727

No 729 (56%) 85 (65%) 644 (53%)

Missing 153 (12%)

Tissue Disorders

Yes 15 (1%) 4 (3%) 11 (1%) 0.064

No 1265 (97%) 143 (97%) 1122 (99%)

Missing 21 (2%)

Cardiac Disorders

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Yes 242 (19%) 36 (25%) 206 (18%) 0.047

No 1048 (80%) 109 (75%) 939 (82%)

Missing 11 (1%)

Vascular Disorders

Yes 526 (40%) 63 (44%) 463 (41%) 0.481

No 756 (58%) 81 (56%) 675 (59%)

Missing 19 (1%)

Number of Comorbid

Conditions 2.5 (1.8) 2.7 (2.0) 2.5 (1.7) 0.074

Missing 6 (0%)

Prior incontinence surgery

Yes 67 (5%) 10 (7%) 57 (5%) 0.344

No 1228 (95%) 137 (93%) 1091 (95%)

Missing 6 (0%)

Prior surgery for prolapse

repair

Yes 242 (19%) 35 (24%) 207 (18%) 0.091

No 1053 (81%) 112 (76%) 941 (82%)

Missing 6 (0%)

POPQ

II 322 (25%) 28 (19%) 294 (26%) 0.1896

III 807 (62%) 101 (69%) 706 (62%)

IV 160 (12%) 18 (12%) 142 (12%)

Missing 12 (1%)

POPQ Ba 2.8 (2.6) 3.0 (2.4) 2.8 (2.6) 0.404

Missing 2 (0%)

POPQ C 0.3 (4.4) 0.7 (4.3) 0.2 (4.4) 0.193

Missing 5 (0%)

POPQ BP 0.4 (3.3) 0.6 (3.3) 0.3 (3.3) 0.453

Missing 4 (0%)

POPQ GH 5.0 (1.5) 5.1 (1.6) 4.9 (1.5) 0.348

Missing 22 (2%)

Anterior repair

Yes 593 (46%) 63 (43%) 530 (46%) 0.482

No 708 (54%) 84 (57%) 624 (54%)

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Posterior repair

Yes 498 (38%) 54 (37%) 444 (38%) 0.683

No 803 (62%) 93 (63%) 710 (62%)

Burch 154 (12%) 22 (15%) 132 (11%) 0.030

Sling/TVT 648 (50%) 57 (39%) 591 (51%)

Other 14 (1%) 3 (2%) 11 (1%)

None 485 (37%) 65 (44%) 420 (36%)

Concurrent hysterectomy or

oopherectomy

Yes 696 (54%) 65 (44%) 631 (55%) 0.017

No 605 (46%) 82 (56%) 523 (45%)

Anesthetic

General 1211 (93%) 133 (91%) 1078 (94%) 0.259

Regional 87 (7%) 13 (9%) 74 (6%)

Missing 3 (0%)

Heavy Lifting Frequency

Never 437 (34%) 56 (43%) 381 (39%) 0.429

1 per Week 113 (9%) 16 (12%) 97 (10%)

Greater Than 1 per Week 246 (19%) 29 (22%) 217 (22%)

Less Than 1 per Month 21(2%) 3(2%) 18(2%)

1 per Month 126(10%) 9(7%) 117(12%)

2 or 3 per Month 173 (13%) 16 (12%) 157 (16%)

Missing 185 (14%)

SF-36 Question 3

Limited a little 456 (35%) 55 (38%) 401 (37%) 0.914

Limited a lot 560 (43%) 63 (44%) 497 (46%)

Not limited at all 209 (16%) 25 (18%) 184 (17%)

Missing 76 (6%)

Strenuous 1.2 (1.7) 1.0 (1.7) 1.2 (1.7) 0.401

Missing 187 (14%)

Activity

Yes 787 (60%) 87 (67%) 700 (71%) 0.415

No 329 (25%) 42 (33%) 287 (29%)

Missing 185 (14%)

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Smoking Status

Current 86 (7%) 15 (10%) 71 (6%) 0.016

Never 788 (61%) 74 (51%) 714 (63%)

Former 413 (32%) 56 (39%) 357 (31%)

Missing 14 (1%)

Lower GI Diagnosis

Yes 195 (15%) 18 (13%) 177 (16%) 0.333

No 1085 (83%) 126 (87%) 959 (84%)

Missing 21 (2%)

Upper GI Diagnosis

Yes 290 (22%) 37 (26%) 253 (22%) 0.361

No 988 (76%) 107 (74%) 881 (78%)

Missing 23 (2%)

Use of anticoagulants

Yes 67 (5%) 9 (6%) 58 (5%) 0.571

No 1234 (95%) 138 (94%) 1096 (95%)

Missing

Vault suspension repair type

¶

Abdominal 322 (25%) 53 (36%) 269 (23%) 0.006

Colpocleisis 184 (14%) 23 (16%) 161(14%)

SSLS 240 (18%) 23 (16%) 217 (19%)

USLS 489 (38%) 41 (28%) 448 (39%)

Other 20 (2%) 4 (3%) 16 (1%)

None 46 (4%) 3 (2%) 43 (4%)

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