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International Urogynecology Journal

Published in:

01-06-2021 | Original Article

Surgical repair of vaginal vault prolapse; a comparison between ipsilateral uterosacral ligament suspension and sacrospinous ligament fixation—a nationwide cohort study

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

Published in: International Urogynecology Journal | Issue 6/2021

Abstract

Introduction and hypothesis

Hysterectomy is frequently performed and associated with increased risk of subsequent genital prolapse including vaginal vault prolapse. Ipsilateral uterosacral ligament suspension (IUSLS) and sacrospinous ligament fixation (SSLF) are two commonly performed surgical techniques to treat vaginal vault prolapse. There is no consensus on the ideal operation technique. The aim of this study was to compare IUSLS and SSLF to treat vaginal vault prolapse based on the number of repeat surgeries.

Methods

Previously hysterectomized patients operated on with IUSLS or SSLF in Denmark in 2010–2016 were included in this nationwide register-based cohort study and followed until June 2017. Data were obtained from Danish National Databases, to which reporting is mandatory by law, entailing high validity and completeness of data. Data were analyzed using Cox proportional hazard regression analysis adjusted for age, preoperative prolapse stage, smoking, BMI, and previous prolapse surgery.

Results

In total, 744 patients were included; 384 underwent IUSLS while 360 underwent SSLF. After 5 years, 6.5% of patients operated on with IUSLS and 21.8% operated on with SSLF had a repeat surgery in the apical compartment and 12.4% and 30.6% in any compartment, respectively. The risk of repeat surgery was 4.8 times higher after SSLF compared to IUSLS [confidence interval (CI): 2.7–8.4] in the apical compartment and 2.4 times higher (CI: 1.2–5.1) in the anterior compartment. No difference was seen in the posterior compartment.

Conclusions

This study finds significantly higher numbers of repeat surgeries after SSLF compared to after IUSLS in a Danish nationwide cohort.

Available only for authorised users

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Title: Surgical repair of vaginal vault prolapse; a comparison between ipsilateral uterosacral ligament suspension and sacrospinous ligament fixation—a nationwide cohort study
Authors: Karen Ruben Husby
Michael Due Larsen
Gunnar Lose
Niels Klarskov
Publication date: 01-06-2021
Publisher: Springer International Publishing
Published in: International Urogynecology Journal / Issue 6/2021
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-020-04515-x

At a glance: The STEP trials

Springer Medicine

Surgical repair of vaginal vault prolapse; a comparison between ipsilateral uterosacral ligament suspension and sacrospinous ligament fixation—a nationwide cohort study

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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