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International Urogynecology Journal

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01-11-2019 | Uterine Prolapse | Original Article

Surgical treatment of primary uterine prolapse: a comparison of vaginal native tissue surgical techniques

Authors: Karen Ruben Husby, Michael Due Larsen, Gunnar Lose, Niels Klarskov

Published in: International Urogynecology Journal | Issue 11/2019

Abstract

Introduction and hypothesis

Uterine prolapse is a common diagnosis. Today no consensus exists on which operation technique is ideal to treat apical prolapse. Vaginal hysterectomy (VH) with suspension of the vaginal cuff is the most frequently used. The popularity of uterus-preserving techniques is increasing. The aim of this study was to compare the efficiency of vaginal native tissue operations to treat primary apical prolapse, evaluated on risk of relapse surgery.

Methods

Data were obtained from the Danish National Patient Registry (NPR), which contains all operations performed in Denmark. Patients operated on for primary apical prolapse in Denmark 2010–2016 were included and followed until 2017. Clinical data were obtained from the Danish Urogynecological Database. Patients who were previously hysterectomized or operated on for prolapse in the apical compartment were excluded. Data were analyzed using Cox proportional hazard regression analysis and adjusted for age, BMI, smoking, preoperative prolapse stage and previous POP operations.

Results

In total, 7247 operations were included. The hazard ratio (HR) for relapse operation in the apical compartment was significantly higher after sacrospinous hysteropexy (SH) compared with the Manchester-Fothergill procedure (MP) [40.2 confidence interval (CI) 21.6–74.7] and VH (8.5 CI: 6.0–12.1). Likewise, the HR was higher in the anterior compartment after SH compared with MP (4.3 CI: 2.9–6.4) and VH (2.8 CI: 2.0–4.0). No convincing difference was found in the posterior compartment. The 5-year reoperation rates were 30%, 7% and 11% after SH, MP, and VH, respectively.

Conclusions

Sacrospinous hysteropexy has exceedingly high numbers of reoperations due to prolapse recurrence.

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Title: Surgical treatment of primary uterine prolapse: a comparison of vaginal native tissue surgical techniques
Authors: Karen Ruben Husby
Michael Due Larsen
Gunnar Lose
Niels Klarskov
Publication date: 01-11-2019
Publisher: Springer International Publishing
Keywords: Uterine Prolapse
Hysterectomy
Published in: International Urogynecology Journal / Issue 11/2019
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-019-03950-9

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Springer Medicine

Surgical treatment of primary uterine prolapse: a comparison of vaginal native tissue surgical techniques

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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