Top

International Urogynecology Journal

Published in:

Open Access 01-02-2010 | Original Article

One-year follow-up after sacrospinous hysteropexy and vaginal hysterectomy for uterine descent: a randomized study

Authors: Viviane Dietz, Carl H. van der Vaart, Yolanda van der Graaf, Peter Heintz, Steven E. Schraffordt Koops

Published in: International Urogynecology Journal | Issue 2/2010

Abstract

Introduction and hypothesis

In a retrospective study, the sacrospinous hysteropexy was associated with a shorter recovery time compared to a vaginal hysterectomy with no differences in anatomical outcomes. No randomized trials are performed.

Methods

Sixty-six women with stage 2–4 uterine descent were randomized for vaginal hysterectomy(31) or sacrospinous hysteropexy(35). Recovery time, anatomical outcomes, functional outcomes, and quality of life were measured.

Results

Length of time to return to work was shorter after a sacrospinous hysteropexy (43 versus 66 days, p = 0.02). The difference in risk for recurrent prolapse stage 2 or more of the apical compartment at 1-year follow-up was 17% (95% confidence interval, 2 to 30) in favor of the vaginal hysterectomy. No differences in quality of life and urogenital symptoms were found.

Conclusions

The sacrospinous hysteropexy for uterine descent is associated with an earlier recovery time, more recurrent apical prolapses but no differences in functional outcomes, and quality of life.

Richardson DA, Scotti RJ, Ostergard DR (1989) Surgical management of uterine prolapse in young women. J Reprod Med 34(6):388–392PubMed

Dietz V, de Jong J, Huisman M, Schraffordt Koops S, Heintz P, van der Vaart H (2007) The effectiveness of the sacrospinous hysteropexy for the treatment of uterovaginal prolapse. Int Urogynecol J 18:1271–1276CrossRef

Dietz V, Huisman M, de Jong JM, Heintz PM, van der Vaart CH (2008) Functional outcome after sacrospinous hysteropexy for uterine descensus. Int Urogynecol J 19(6):747–752CrossRef

Brummen HJ, van de Pol G, Aalders CIM, Heintz APM, van der Vaart CH (2003) Sacrospinous hysteropexy compared to vaginal hysterectomy as primary surgical treatment for a descensus uteri: effects on urinary symptoms. Int Urogynecol J 14:350–355CrossRef

Maher CF, Cary MP, Slack CJ, Murray CJ, Milligan M, Schluter P (2001) Uterine preservation or hysterectomy at sacrospinous colpopexy for uterovaginal prolapse. Int Urogynecol J 12:381–385CrossRef

Hefni M, El-Toukhy T, Bhaumik J, Katsimanis E (2003) Sacrospinous cervicocolpopexy with uterine conservation for uterovaginal prolapse in elderly women: an evolving concept. Am J Obstet Gynecol 188(3):645–650CrossRefPubMed

Jeng CJ, Yang YC, Tzeng CR, Shen J, Wang LR (2005) Sexual functioning after vaginal hysterectomy or transvaginal sacrospinous uterine suspension for uterine prolapse. J Reprod Med 50:669–674PubMed

Walters MD (2008) Uterovaginal prolapse in women desiring uterine preservation. Int Urogynecol J 19(11):1465–1470CrossRef

Bump RC, Mattiasson A, Bo K et al (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17CrossRefPubMed

10.

van der Vaart CH, de Leeuw JR, Roovers JP, Heintz AP (2003) Measuring health-related quality of life in women with urogenital dysfunction: the urogenital distress inventory and incontinence impact questionnaire revisited. Neurourol Urodyn 22:97–104CrossRefPubMed

11.

Hirsch HA, Kaser O, Iklé FA (1997) Atlas of Gynecologic Surgery. Thieme-Stuttgard, New York, pp 226–238

12.

Ulmsten U, Hendriksson L, Johnson P, Vahros G (1996) An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence. Int Urogynecol J 7(2):81–85CrossRef

13.

Mazumdar S, Liu KS, Houck PR, Reynolds CF (1999) Intent-to-treat analysis for longitudinal clinical trials: coping with the challenge of missing values. J Psychiatric Research 33:87–95CrossRef

14.

Altman DG, David Machin D, Trevor N Bryant TN, Gardner MJ (2000) Statistics with Confidence. BMJ Books 2nd Edition, London, ISBN: 0 7279 1375 1

15.

Roovers JP, van der Vaart CH, van der Bom JG, van Leeuwen JH, Scholten PC, Heintz AP (2004) A randomized controlled trial comparing abdominal and vaginal prolapse surgery: effects on urogenital function. BJOG 111:50–56CrossRefPubMed

16.

Schraffordt DV, Koops SE, van der Vaart CH (2008) Vaginal surgery for uterine descent: which options do we have? A literature review. Int Urogynecol J 20(3):349–356

17.

Lin TY, Su TH, Wang YL, Lee MY, Hsieh CH, Wang KG, Chen GD (2005) Risk factors for failure of transvaginal sacrospinous uterine suspension in the treatment of uterovaginal prolapse. J Formos Med Assoc 4:249–253

18.

Carey MP, Slack MC (1994) Transvaginal sacrospinous colpopexy for vault and marked uterovaginal prolapse. Br J Obstet Gynecol 101:536–540

19.

Smilen SW, Saine J, Wallach SJ, Porges RF (1998) The risk of cystocele after sacrospinous ligament fixation. Am J Obstet Gynecol 179:1465–1471PubMed

Title: One-year follow-up after sacrospinous hysteropexy and vaginal hysterectomy for uterine descent: a randomized study
Authors: Viviane Dietz
Carl H. van der Vaart
Yolanda van der Graaf
Peter Heintz
Steven E. Schraffordt Koops
Publication date: 01-02-2010
Publisher: Springer-Verlag
Published in: International Urogynecology Journal / Issue 2/2010
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-009-1014-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

One-year follow-up after sacrospinous hysteropexy and vaginal hysterectomy for uterine descent: a randomized study

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 2/2010

Complete transurethral bladder eversion 3 months after hemipelvectomy

Postoperative transvaginal tape mobilization in preventing voiding difficulty after tension-free vaginal tape procedures

Urinary incontinence in nulliparous women before and during pregnancy: prevalence, incidence, and associated risk factors

Risk factors of treatment failure of midurethral sling procedures for women with urinary stress incontinence

Surgical strategies for women with pelvic organ prolapse and urinary stress incontinence

Metabolic profile of glycosaminoglycans in bladder and urethra of female rats during and after pregnancy