Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
International Urogynecology Journal
Published in: International Urogynecology Journal 7/2022

29-09-2021 | Hysterectomy | Original Article

Intermediate term outcomes after transvaginal uterine-preserving surgery in women with uterovaginal prolapse

Authors: Lisa C. Hickman, Misha C. Tran, Marie Fidela R. Paraiso, Mark D. Walters, Cecile A. Ferrando

Published in: International Urogynecology Journal | Issue 7/2022

Login to get access

Abstract

Introduction and hypothesis

There is growing interest in and performance of uterine-preserving prolapse repairs. We hypothesized that there would be no difference in pelvic organ prolapse (POP) recurrence 2 years following transvaginal uterosacral ligament hysteropexy (USLH) and sacrospinous ligament hysteropexy (SSLH).

Methods

This is a retrospective cohort study with a cross-sectional survey of women who underwent transvaginal uterine-preserving POP surgery from May 2016 to December 2017. Patients were included if they underwent either USLH or SSLH. POP recurrence was defined as a composite of subjective symptoms and/or retreatment. A cross-sectional survey was used to assess pelvic floor symptoms and patient satisfaction.

Results

A total of 47 women met the criteria. Mean age was 52.8 ± 12.5 years, and all had a preoperative POP-Q stage of 2 (55.3%) or 3 (44.7%). Thirty (63.8%) underwent SSLH and 17 (36.2%) underwent USLH. There were no differences in patient characteristics or perioperative data. There was no difference in composite recurrence (26.7% [8] vs 23.5% [4]) and retreatment (6.7% [2] vs 0%) retrospectively between SSLH and USLH groups at 22.6 months. Survey response rate was 80.9% (38) with a response time of 30.7 (28.0–36.6) months. The majority of patients (84.2%) reported POP symptom improvement, and both groups reported great satisfaction (89.5%). In respondents, 13.2% (5) reported subjective recurrence and 5.3% (2) underwent retreatment, with no differences between hysteropexy types. There were no differences in other pelvic floor symptoms.

Conclusions

Although 1 in 4 women experienced subjective POP recurrence after transvaginal uterine-preserving prolapse repair and <5% underwent retreatment at 2 years, our results must be interpreted with caution given our small sample size. No differences in outcomes were identified between hysteropexy types; however, additional studies should be performed to confirm these findings. Both hysteropexy approaches were associated with great patient satisfaction.
Appendix
Available only for authorised users
Literature
1.
Whiteman MK, Hillis SD, Jamieson DJ, et al. Inpatient hysterectomy surveillance in the United States, 2000–2004. Am J Obstet Gynecol. 2008;198(1):34.e1–7.CrossRef
2.
Wright JD, Herzog TJ, Tsui J, et al. Nationwide trends in the performance of inpatient hysterectomy in the United States. Obstet Gynecol. 2013;122(2):233–41.CrossRef
3.
Frick AC, Barber MD, Paraiso MFR, Ridgeway B, Jelovsek JE, Walters MD. Attitudes toward hysterectomy in women undergoing evaluation for Uterovaginal prolapse. Female Pelvic Med Reconstr Surg. 2013;19(2):103–9.CrossRef
4.
Good MM, Korbly N, Kassis NC, et al. Prolapse-related knowledge and attitudes toward the uterus in women with pelvic organ prolapse symptoms. Am J Obstet Gynecol. 2013;209(5):481.e1–6.CrossRef
5.
Madsen AM, Raker C, Sung VW. Trends in hysteropexy and apical support for uterovaginal prolapse in the United States from 2002 to 2012. Female Pelvic Med Reconstr Surg. 2017;23(6):365–71.CrossRef
6.
Ridgeway BM, Cadish L. Hysteropexy. Clin Obstet Gynecol. 2017;60(2):312–23.CrossRef
7.
Gutman R, Maher C. Uterine-preserving POP surgery. Int Urogynecol J. 2013;24(11):1803–13.CrossRef
8.
Maher CF, Cary MP, Slack MC, et al. Uterine preservation or hysterectomy at sacrospinous colpopexy for uterovaginal prolapse? Int Urogynecol J. 2001;12(6):381–4; discussion 384–5.CrossRef
9.
Dietz V, Huisman M, de Jong JM, et al. Functional outcome after sacrospinous hysteropexy for uterine descensus. Int Urogynecol J Pelvic Floor Dysfunct. 2008;19(6):747–52.CrossRef
10.
Dietz V, Van Der Vaart CH, Van Der Graaf Y, et al. One-year follow-up after sacrospinous hysteropexy and vaginal hysterectomy for uterine descent: a randomized study. Int Urogynecol J. 2010;21(2):209–16.CrossRef
11.
van Brummen HJ, van de Pol G, Aalders CIM, et al. Sacrospinous hysteropexy compared to vaginal hysterectomy as primary surgical treatment for a descensus uteri: effects on urinary symptoms. Int Urogynecol J Pelvic Floor Dysfunct. 2003;14(5):350–5; discussion 355.CrossRef
12.
Jeng C-J, Yang Y-C, Tzeng C-R, et al. Sexual functioning after vaginal hysterectomy or transvaginal sacrospinous uterine suspension for uterine prolapse: a comparison. J Reprod Med. 2005;50(9):669–74.PubMed
13.
Milani R, Manodoro S, Cola A, et al. Transvaginal uterosacral ligament hysteropexy versus hysterectomy plus uterosacral ligament suspension: a matched cohort study. Int Urogynecol J. 2019;31(9):1867–72.CrossRef
14.
Romanzi LJ, Tyagi R. Hysteropexy compared to hysterectomy for uterine prolapse surgery: does durability differ? Int Urogynecol J. 2012;23(5):625–31.CrossRef
15.
Milani R, Frigerio M, Manodoro S, et al. Transvaginal uterosacral ligament hysteropexy: a retrospective feasibility study. Int Urogynecol J. 2017;28(1):73–6.CrossRef
16.
Aserlind A, Garcia AN, Medina CA. Uterus-sparingsurgery—outcomes of transvaginal uterosacral ligament hysteropexy. J Minim Invasive Gynecol. 2020;28(1):100–6.
17.
Barber MD, Walters MD, Bump RC. Short forms of two condition-specificquality-of-life questionnaires for women with pelvic floor disorders (PFDI-20 and PFIQ-7). Am J Obstet Gynecol. 2005;193(1):103–13.CrossRef
18.
Rogers RG, Coates KW, Kammerer-Doak D, et al. A short form of the pelvic organ prolapse/urinary incontinence sexual questionnaire (PISQ-12). Int Urogynecol J Pelvic Floor Dysfunct. 2003;14(3):164–8; discussion 168.CrossRef
19.
Srikrishna S, Robinson D, Cardozo L. Validation of the patient global impression of improvement (PGI-I) for urogenital prolapse. Int Urogynecol J. 2010;21(5):523–8.CrossRef
20.
Sandvik H, Espuna M, Hunskaar S. Validity of the incontinence severity index: comparison with pad-weighing tests. Int Urogynecol J Pelvic Floor Dysfunct. 2006;17(5):520–4.CrossRef
21.
Harris PA, Taylor R, Thielke R, et al. Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42(2):377–81.CrossRef
22.
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(2):129–146.e2.CrossRef
23.
Meriwether KV, Balk EM, Antosh DD, et al. Uterine-preserving surgeries for the repair of pelvic organ prolapse: a systematic review with meta-analysis and clinical practice guidelines. Int Urogynecol J. 2019;30(4):505–22.CrossRef
24.
Korbly NB, Kassis NC, Good MM, et al. Patient preferences for uterine preservation and hysterectomy in women with pelvic organ prolapse. Am J Obstet Gynecol. 2013;209(5):470.e1–6.CrossRef
25.
Wieslander CK, Roshanravan SM, Wai CY, Schaffer JI, Corton MM. Uterosacral ligament suspension sutures: anatomic relationships in unembalmed female cadavers. Am J Obstet Gynecol. 2007;197(6):672.e1–6.CrossRef
26.
Hickman LC, Tran MC, Thomas TN, et al. Vaginal uterosacral ligament hysteropexy: technique and clinical outcomes. In: AUGS PFD Week. Chicago, Illinois; Female Pelvic Med Reconstr Surg. 2018; 24(5S):S158.
Metadata
Title
Intermediate term outcomes after transvaginal uterine-preserving surgery in women with uterovaginal prolapse
Authors
Lisa C. Hickman
Misha C. Tran
Marie Fidela R. Paraiso
Mark D. Walters
Cecile A. Ferrando
Publication date
29-09-2021
Publisher
Springer International Publishing
Keyword
Hysterectomy
Published in
International Urogynecology Journal / Issue 7/2022
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-021-04987-5

Other articles of this Issue 7/2022

International Urogynecology Journal 7/2022 Go to the issue

Original Article

Effect of vaginal estrogen in postmenopausal women using vaginal pessary for pelvic organ prolapse treatment: a randomized controlled trial

Original Article

Transvaginal repair of anterior vaginal wall prolapse with polyvinylidene fluoride (PVDF) mesh: an alternative for previously restricted materials?

Letter to the Editor

Letter to the editor: absorbable versus non-absorbable sutures for vaginal mesh attachment during sacrocolpopexy: a randomized controlled trial

Original Article

Pessary fitting for pelvic organ prolapse: parameters associated with specific reasons for failure

Review Article

The effect of pelvic floor muscle training for women with pelvic organ prolapse: a meta-analysis

Original Article

Practice pattern variation: treatment of pelvic organ prolapse in The Netherlands