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International Urogynecology Journal

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01-09-2017 | Review Article

Sacrospinous hysteropexy: review and meta-analysis of outcomes

Authors: Shveta Kapoor, Kanapathippillai Sivanesan, Jessica Amy Robertson, Mayooran Veerasingham, Vishal Kapoor

Published in: International Urogynecology Journal | Issue 9/2017

Abstract

Introduction

Sacrospinous hysteropexy is a uterine-preserving procedure for treatment of apical prolapse. We present a literature review evaluating the sacrospinous hysteropexy procedure and its current place in the surgical management of pelvic organ prolapse. Additionally, to assess the efficacy of the procedure, we performed a meta-analysis of studies comparing sacrospinous hysteropexy to vaginal hysterectomy and repair in terms of anatomical outcomes, complications, and repeat surgery.

Methods

Major literature databases including MEDLINE (1946 to 2 April 2016), Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 3), and Embase (1947 to 2 April 2016) were searched for relevant studies. We used Cochrane Collaboration’s Review Manager software to perform meta-analysis of randomized controlled studies and observational studies.

Results

Vaginal sacrospinous hysteropexy was first performed in 1989 and is similar in technique to sacrospinous colpopexy. Two randomized controlled trials and four cohort studies (n = 651) were included in the meta-analysis. Apical failure rates after sacrospinous hysteropexy versus vaginal hysterectomy were not significantly different, although the trend favored vaginal hysterectomy [odds ratio (OR) 2.08; 95% confidence interval (CI) 0.76–5.68]. Rates of repeat surgery for prolapse were not significantly different between the two groups (OR 0.99; 95% CI 0.41–2.37). The most significant disadvantage of uterine-preservation prolapse surgery when compared with hysterectomy is the lack of prevention and diagnosis of uterine malignancy.

Conclusion

Sacrospinous hysteropexy is a safe and effective procedure for pelvic organ prolapse and has comparable outcomes to vaginal hysterectomy with repair.

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Title: Sacrospinous hysteropexy: review and meta-analysis of outcomes
Authors: Shveta Kapoor
Kanapathippillai Sivanesan
Jessica Amy Robertson
Mayooran Veerasingham
Vishal Kapoor
Publication date: 01-09-2017
Publisher: Springer London
Published in: International Urogynecology Journal / Issue 9/2017
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-017-3291-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Sacrospinous hysteropexy: review and meta-analysis of outcomes

Abstract

Introduction

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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