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01-05-2024 | Hysterectomy | Special Contribution

Vaginal Hysterectomy and Pelvic Organ Prolapse: History and Recent Developments

Authors: Renaud de Tayrac, Michel Cosson

Published in: International Urogynecology Journal

Abstract

Introduction and hypothesis

Vaginal hysterectomy (VH) was described as far back as 120 CE. However, it was not till the mid-1900s when reconstructive procedures were introduced to mitigate the risk of, or treat, pelvic organ prolapse in relation to VH. Furthermore, routine hysterectomy, particularly VH, has long been advocated in prolapse surgery. However, this indication is now questionable.

Methods

Literature review to provide an overview of current evidence and experts’ opinion regarding the relationship between VH and pelvic organ prolapse. The review presents a historical perspective on the role of VH in the management of pelvic organ prolapse, the current debate on the usefulness of the procedure in this context, a practical guide on operative techniques used during VH and the impact of recent surgical developments on its use.

Results

Vaginal hysterectomy is a well-established technique that is still superior to laparoscopic hysterectomy for benign gynecological disease, although more surgically challenging. However, it is possible that some contemporary techniques, such as vaginal natural orifice transluminal endoscopic surgery, may overcome some of these challenges, and hence increase the number of hysterectomies performed via the vaginal route. Although patients should be counselled about uterine-sparing reconstructive surgery, vaginal hysterectomy continues to be a major surgical procedure in reconstructive pelvic floor surgery.

Conclusions

Therefore, it is prudent to continue to train residents in vaginal surgical skills to ensure that they continue to provide safe, cost-effective, and comprehensive patient care.

Sutton C. Hysterectomy: a historical perspective. Baillieres Clin Obstet Gynaecol. 1997;11(1):1–22. https://doi.org/10.1016/S0950-3552(97)80047-8.CrossRef

Marquini GV, de Oliveira LM, Martins SB, et al. Historical perspective of vaginal hysterectomy: the resilience of art and evidence-based medicine in the age of technology. Arch Gynecol Obstet. 2022;307:1377–84. https://doi.org/10.1007/s00404-022-06607-z.CrossRefPubMed

McCall ML. Posterior culdeplasty: surgical correction of enterocele during vaginal hysterectomy; a preliminary report. Obstet Gynecol 1957;10(6):595–602. https://doi.org/10.1097/00006250-195712000-00001.CrossRefPubMed

Richter K. The surgical treatment of the prolapsed vaginal fundus after uterine extirpation. A contribution on Amreich’s the sacrotuberal vaginal fixation. Geburtshilfe Frauenheilkd. 1967;27:941–54.PubMed

Randall CL, Nichols DH. Surgical treatment of vaginal inversion. Obstet Gynecol. 1971;38:327–32.PubMed

Richter K, Dargent D. Spinous fixation (vaginae fixatio sacrospinalis) in the treatment of vaginal prolapse after hysterectomy. J Gynecol Obstet Biol Reprod (Paris). 1986;15:1081–8.PubMed

Pickett CM, Seeratan DD, Mol BWJ, et al. Surgical approach to hysterectomy for benign gynaecological disease. Cochrane Database Syst Rev 2023;8(8):CD003677.https://doi.org/10.1002/14651858.CD003677.pub6.CrossRefPubMed

Meriwether KV, Antosh DD, Olivera CK, et al. Uterine preservation vs hysterectomy in pelvic organ prolapse surgery: a systematic review with meta-analysis and clinical practice guidelines. Am J Obstet Gynecol. 2018;219:129–46.e2. https://doi.org/10.1016/j.ajog.2018.01.018.CrossRefPubMed

Maher C, Yeung E, Haya N, et al. Surgery for women with apical vaginal prolapse. Cochrane Database Syst Rev 2023;7(7):CD012376. https://doi.org/10.1002/14651858.CD012376.pub2.CrossRefPubMed

10.

Ramage K, Ducey A, Scime NV, et al. Factors affecting women’s decision between uterine-preserving versus hysterectomy-based surgery for pelvic organ prolapse. Womens Health. 2023;19:17455057231181015. https://doi.org/10.1177/17455057231181015.CrossRef

11.

Chang OH, Shepherd JP, Ridgeway BM, Cadish LA. Hysterectomy versus hysteropexy at the time of native tissue pelvic organ prolapse repair: a cost-effectiveness analysis. Female Pelvic Med Reconstr Surg. 2021;27:e277–81. https://doi.org/10.1097/SPV.0000000000000902.CrossRefPubMed

12.

Urdzík P, Kalis V, Blaganje M, et al. Pelvic organ prolapse and uterine preservation: a survey of female gynecologists (POP-UP survey). BMC Womens Health. 2020;20:241. https://doi.org/10.1186/s12905-020-01105-3.CrossRefPubMedPubMedCentral

13.

De Tayrac R, Antosh DD, Baessler K, et al. Summary: 2021 international consultation on incontinence evidence-based surgical pathway for pelvic organ prolapse. J Clin Med. 2022;11(20):6106.CrossRefPubMedPubMedCentral

14.

Antosh DD, High R, Brown HW, et al. Feasibility of prophylactic salpingectomy during vaginal hysterectomy. Am J Obstet Gynecol. 2017;217(5):605.e1–5. https://doi.org/10.1016/j.ajog.2017.07.017.CrossRefPubMed

15.

Catanzarite T, Eskander RN. Opportunistic salpingectomy at the time of urogynecologic surgery: why, in whom, and how? Female Pelvic Med Reconstr Surg. 2020;26:401–6. https://doi.org/10.1097/SPV.0000000000000741.CrossRefPubMed

16.

Chohan L, Richardson DL. ACOG committee opinion no. 774 summary: opportunistic salpingectomy as a strategy for epithelial ovarian cancer prevention. Obstet Gynecol. 2019;133:842–3. https://doi.org/10.1097/AOG.0000000000003165.CrossRef

17.

Greene KA, Wyman AM, Tamhane N, et al. Adnexal surgery at the time of hysterectomy in women 65 years and older undergoing hysterectomy for prolapse: do practice trends differ by route of surgery? Int Urogynecol J. 2021;32(8):2185–93. https://doi.org/10.1007/s00192-020-04663-0.CrossRefPubMed

18.

Lua LL, Kosiorek HE, Wasson MN. Feasibility of oophorectomy at the time of vaginal hysterectomy in patients with pelvic organ prolapse. J Minim Invasive Gynecol. 2019;26(6):1063–9. https://doi.org/10.1016/j.jmig.2018.10.010.CrossRefPubMed

19.

Slopnick EA, Sheyn DD, Chapman GC, et al. Adnexectomy at the time of vaginal hysterectomy for pelvic organ prolapse. Int Urogynecol J. 2020;31(2):373–9. https://doi.org/10.1007/s00192-019-03967-0CrossRefPubMed

20.

Shveiky D, Kudish BI, Iglesia CB, et al. Effects of bilateral salpingo-oophorectomy at the time of hysterectomy on pelvic organ prolapse: results from the Women’s Health Initiative trial. Menopause 2015;22(5):483–8. https://doi.org/10.1097/GME.0000000000000375.CrossRefPubMed

21.

Evans EC, Matteson KA, Orejuela FJ, et al. Salpingo-oophorectomy at the time of benign hysterectomy: a systematic review. Obstet Gynecol. 2016;128(3):476–85.CrossRef

22.

Cusimano MC, Ferguson SE, Moineddin R, et al. Ovarian cancer incidence and death in average-risk women undergoing bilateral salpingo-oophorectomy at benign hysterectomy. Am J Obstet Gynecol. 2022;226:220.e1–26. https://doi.org/10.1016/j.ajog.2021.09.020.CrossRefPubMed

23.

Merlier M, Collinet P, Pierache A, et al. Is V-NOTES hysterectomy as safe and feasible as outpatient surgery compared with vaginal hysterectomy? J Minim Invasive Gynecol. 2022;29(5):665–72. https://doi.org/10.1016/j.jmig.2022.01.007.CrossRefPubMed

24.

Liu J, Kohn J, Fu H, et al. Transvaginal natural orifice transluminal endoscopic surgery for sacrocolpopexy: a pilot study of 26 cases. J Minim Invasive Gynecol. 2019;26(4):748–53. https://doi.org/10.1016/j.jmig.2018.08.009.CrossRefPubMed

25.

Aharoni S, Matanes E, Lauterbach R, et al. Transvaginal natural orifice transluminal endoscopic versus conventional vaginal hysterectomy with uterosacral ligament suspension for apical compartment prolapse. Eur J Obstet Gynecol Reprod Biol. 2021;260:203–7. https://doi.org/10.1016/j.ejogrb.2021.03.040.CrossRefPubMed

26.

Lu Z, Chen Y, Wang X, et al. Transvaginal natural orifice transluminal endoscopic surgery for uterosacral ligament suspension: pilot study of 35 cases of severe pelvic organ prolapse. BMC Surg. 2021;21(1):286. https://doi.org/10.1186/s12893-021-01280-6.CrossRefPubMedPubMedCentral

27.

Lerner VT, May G, Iglesia CB. Vaginal natural orifice transluminal endoscopic surgery revolution: the next frontier in gynecologic minimally invasive surgery. JSLS. 2023;27(1):e2022.00082.CrossRefPubMedPubMedCentral

Title: Vaginal Hysterectomy and Pelvic Organ Prolapse: History and Recent Developments
Authors: Renaud de Tayrac
Michel Cosson
Publication date: 01-05-2024
Publisher: Springer International Publishing
Keywords: Hysterectomy
Salpingectomy
Published in: International Urogynecology Journal
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-024-05783-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Vaginal Hysterectomy and Pelvic Organ Prolapse: History and Recent Developments

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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