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International Urogynecology Journal
Published in: International Urogynecology Journal 1/2018

01-01-2018 | Original Article

Laparoscopic sacrohysteropexy versus vaginal hysterectomy for uterovaginal prolapse using validated questionnaires: 2-year prospective study

Authors: Farah Lone, Tamara Curnow, Sarah Anne Thomas

Published in: International Urogynecology Journal | Issue 1/2018

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Abstract

Introduction

Surgical options for uterovaginal prolapse can be categorized into uterus conservation—e.g., laparoscopic sacrohysteropexy (LSHP) or vaginal hysterectomy (VH). There is insufficient reliable information on long-term comparative outcomes of these procedures. The primary aim of this study was to compare subjective and objective outcomes of LSHP and VH. The secondary aim was to record adverse events, recurrent prolapse, and new-onset stress urinary incontinence (SUI) up to 2 years.

Methods

Women with symptomatic uterovaginal prolapse who opted for either LSHP or VH were included. Subjective outcomes were compared at 1 and 2 years from baseline using the validated questionnaires. Objective/anatomical outcomes using the Pelvic Organ Prolapse Quantification (POP-Q) system were assessed before and at 3 months after surgery. Adverse events, recurrent prolapse, and new-onset SUI was recorded up to 2 years.

Results

The study assessed 226 women with uterovaginal prolapse; 125 opted for surgery (44 LSHP, 81 VH). There was no statistically significant difference in symptom domains between groups at baseline and 1 and 2 years. At 3 months POP-Q, greater improvement was seen in points Ba and Ap in the LSHP group compared to VH group and smaller genital hiatus was seen in the VH group. Adverse events, recurrent prolapse, or new-onset SUI were not significantly different in the two groups.

Conclusions

Both LSHP and VH are effective surgical options for uterovaginal prolapse. At 2 years, both procedures had similar improvement in symptom domains, overall scores, adverse events, recurrent prolapse, and new-onset SUI. Long-term randomized studies are needed.
Literature
1.
Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL. Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol. 1997;89:501–6.CrossRefPubMed
2.
Digesu GA, Chaliha C, Salvatore S, Hutchings A, Khullar V. The relationship of vaginal prolapse severity to symptoms and quality of life. BJOG. 2005;112:971–6.CrossRefPubMed
3.
Dallenbach P, Kaelin-Gambirasio I, Jacob S, Dubuisson JB, Boulvain M. Incidence rate and risk factors for vaginal vault prolapse repair after hysterectomy. Int Urogynecol J Pelvic Floor Dysfunct. 2008;19(12):1623–9.CrossRefPubMed
4.
Zucchi A, Lazzeri M, Porena M, Mearini L, Costantini E. Uterus preservation in pelvic organ prolapse surgery. Nat Rev Urol. 2010;7(11):626–33.CrossRefPubMed
5.
Price N, Jackson SR, Avery K, Brookes ST, Abrams P. Development and psychometric evaluation of the ICIQ vaginal symptoms questionnaire: the ICIQ-VS. BJOG. 2006;113(6):700–12.CrossRefPubMed
6.
Avery K, Donovan J, Peters T, Shaw C, Gotoh M, Abrams P. ICIQ: a brief and robust measure for evaluating the symptoms and impact of urinary incontinence. Neurourol Urodyn. 2004;23(4):322–30.CrossRefPubMed
7.
Bump RC, Mattiasson A, Bo K, Brubaker LP, DeLancey JO, Klarskov P, et al. The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol. 1996;175(1):10–7.CrossRefPubMed
8.
Rahmanou P, Price N, Jackson SR. Laparoscopic hysteropexy versus vaginal hysterectomy for the treatment of uterovaginal prolapse: aprospective randomized pilot study. Int Urogynecol J. 2015;26:1687–94.CrossRefPubMed
9.
Rahmanou P, Price N, Jackson SR. Laparoscopic hysteropexy: a novel technique for uterine preservation surgery. Int Urogynecol J. 2014;25(1):139–40.CrossRefPubMed
10.
Rahmanou P, White B, Price N, Jackson SR. Laparoscopic hysteropexy: 1- to 4-year follow-up of women postoperatively. Int Urogynecol J. 2014;25(1):131–8.CrossRefPubMed
11.
Price N, Slack A, Jackson SR. Laparoscopic hysteropexy: the initial results of a uterine suspension procedure for uterovaginal prolapse. BJOG Int J Obstet Gynaecol. 2010;117(1):62–6813.CrossRef
12.
Jha S, Moran P. The UK national prolapse survey: 5 years on. Int Urogynecol J. 2011;22(5):517–28.CrossRefPubMed
13.
McCall ML. Posterior culdeplasty; surgical correction of enterocele during 395 vaginal hysterectomies; a preliminary report. Obstet Gynecol. 1957;10:595–602.CrossRefPubMed
14.
15.
16.
Maher C, Baessler K, Glazener CMA, Adams EJ, Hagen S. Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev. 2007 (3):CD004014. doi:10.​1002/​14651858
17.
18.
Kapoor DS, Thakar R, Sultan AH, Oliver R. Conservative versus surgical management of prolapse: what dictates patient choice? Int Urogynecol J Pelvic Floor Dycfunct. 2009;20(10):1157–61.CrossRef
19.
Abdool Z, Thakar R, Sultan AH, Oliver R. Prospective evaluation of outcome of vaginal pessaries versus surgery in women with symptomatic pelvic organ prolapse. Int Urogynecol J. 2011;22:273–8.CrossRefPubMed
20.
Lone FW, Thakar R, Sultan AH, Karamalis G. A 5-year prospective study of vaginal pessary use for pelvic organ prolapse. Int J Gynecol Obstet. 2011;114:56–9.CrossRef
21.
Dietz V, Van der Vaart CH, Van der Graaf Y, Heintz P, Schraffordt Koops SE. One-year follow-up after sacrospinous hysteropexy and vaginal hysterectomy for uterine descent: a randomized study. Int Urogynecol J. 2010;21(2):209–16.CrossRefPubMed
22.
Lo TS, Pue LB, Hung TH, Wu PY, Tan YL. Long-term outcome of native tissue reconstructive vaginal surgery for advanced pelvic organ prolapse at 86 months: hysterectomy versus hysteropexy. J Obstet Gynaecol Res. 2015;41(7):1099–107.CrossRefPubMed
23.
Lone FW, Thakar R, Sultan AH. One-year prospective comparison of vaginal pessaries and surgery for pelvic organ prolapse using the validated ICIQ-VS and ICIQ-UI (SF) questionnaires. Int Urogynecol J. 2015;26(9):1305–12.CrossRefPubMed
24.
Maher C, Feiner B, Baessler K, Christmann-Schmid C, Haya N, Brown J (2016) Surgery for women with apical vaginal prolapse. Cochrane Database Syst Rev. 2016;(10): CD012376. doi:10.​1002/​14651858.​CD012376.
25.
Weber AM, Walters MD, Schover LR, Church JM, Piedmonte MR. Functional outcomes and satisfaction after abdominal hysterectomy. Obstet Gynecol. 1999;181(3):530–5.
26.
Benson JT, Lucente V, McClellan E. Vaginal versus abdominal reconstructive surgery for the treatment of pelvic support defects: a prospective randomized study with long-term outcome evaluation. Obstet Gynecol. 1996;175(6):1418–22.
27.
Maher CF, Qatawneh AM, Dwyer PL, Carey MP, Cornish A, Schluter PJ. Abdominal sacral colpopexy or vaginal sacrospinous colpopexy for vaginal vault prolapse: a prospective randomized study. Obstet Gynecol. 2004;190(1):20–6.
28.
29.
Roovers JP, Oelke M. Clinical relevance of urodynamic investigation tests prior to surgical correction of genital prolapse: a literature review. Int Urogynecol J Pelvic Floor Dysfunct. 2007;18(4):455–60.CrossRefPubMed
30.
Altman D, Vayrynen T, Engh ME, Axelsen S, Falconer C, Nordic. Transvaginal mesh group Anterior colporrhaphy versus transvaginal mesh for pelvic-organ prolapse. N Engl J Med. 2011;364(19):1826–36.CrossRefPubMed
Metadata
Title
Laparoscopic sacrohysteropexy versus vaginal hysterectomy for uterovaginal prolapse using validated questionnaires: 2-year prospective study
Authors
Farah Lone
Tamara Curnow
Sarah Anne Thomas
Publication date
01-01-2018
Publisher
Springer London
Published in
International Urogynecology Journal / Issue 1/2018
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-017-3405-5

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