Anatomical and functional outcomes after hysterectomy and bilateral sacrospinous ligament fixation for stage IV uterovaginal prolapse: a prospective case series
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| Title: | Anatomical and functional outcomes after hysterectomy and bilateral sacrospinous ligament fixation for stage IV uterovaginal prolapse: a prospective case series |
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| Authors: | Christl Reisenauer, Tilemachos Kavvadias, Sara Y. Brucker, Birgitt Schoenfisch |
| Source: | BMC Urol BMC Urology, Vol 20, Iss 1, Pp 1-7 (2020) |
| Publisher Information: | Springer Science and Business Media LLC, 2020. |
| Publication Year: | 2020 |
| Subject Terms: | Ligaments, Native tissue repair, Pelvic organ prolapse, Bilateral sacrospinous ligament fixation, Middle Aged, Hysterectomy, Severity of Illness Index, Diseases of the genitourinary system. Urology, Pelvic Organ Prolapse, 3. Good health, 03 medical and health sciences, Gynecologic Surgical Procedures, Treatment Outcome, 0302 clinical medicine, Female [MeSH], Reconstructive urology, Aged [MeSH], Hysterectomy [MeSH], Self Report [MeSH], Humans [MeSH], Prospective Studies [MeSH], Severity of Illness Index [MeSH], Treatment Outcome [MeSH], Middle Aged [MeSH], Pelvic Organ Prolapse/surgery [MeSH], Ligaments/surgery [MeSH], Gynecologic Surgical Procedures/methods [MeSH], Research Article, Humans, Female, RC870-923, Prospective Studies, Self Report, Aged |
| Description: | Background Aim of this study is to examine pelvic floor symptoms, anatomical results and patients’ satisfaction after sacrospinous vaginal fixation for stage 4 pelvic organ prolapse. Methods All patients with stage 4 pelvic organ prolapse were treated with vaginal hysterectomy, native tissue cystocele and rectocele repair and bilateral sacrospinous vaginal fixation. Anatomical and functional outcomes according to the POPq classification system and the German version of the Australian pelvic floor questionnaire were assessed. Changes between baseline, first follow-up and second follow-up were assessed by the paired Wilcoxon rank test using R, version 3.5.1. Results 20 patients were included in the study. Scores in all four domains of the pelvic floor symptom questionnaire (bladder, bowel, prolapse, sexual function) were significantly improved at 6 and 12-months follow-up. One patient presented with a symptomatic stage 3 cystocele that needed a second surgical intervention and two patients needed surgery due to a de novo stress urinary incontinence. There were no perioperative adverse events and all patients reported full satisfaction after surgery. Conclusions The vaginal approach with hysterectomy, native tissue repair and bilateral sacrospinous vaginal fixation seems to be a safe and effective method for the treatment of advanced stage POP, offering excellent relief in all pelvic floor symptoms. Trial registration ClinicalTrials.gov (NCT 02998216), December 20th, 2016. Prospectively registered. |
| Document Type: | Article Conference object Other literature type |
| Language: | English |
| ISSN: | 1471-2490 |
| DOI: | 10.1186/s12894-020-00694-3 |
| Access URL: | https://bmcurol.biomedcentral.com/track/pdf/10.1186/s12894-020-00694-3 https://pubmed.ncbi.nlm.nih.gov/32814553 https://doaj.org/article/5823ab403eb84a66b2070294ae000e3d https://bmcurol.biomedcentral.com/articles/10.1186/s12894-020-00694-3 https://link.springer.com/article/10.1186/s12894-020-00694-3 https://pubmed.ncbi.nlm.nih.gov/32814553/ http://www.ncbi.nlm.nih.gov/pubmed/32814553 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7439719 https://www.ncbi.nlm.nih.gov/pubmed/32814553 https://repository.publisso.de/resource/frl:6464129 |
| Rights: | CC BY |
| Accession Number: | edsair.doi.dedup.....d40bca3f085190413e76c5f65a7b4d5d |
| Database: | OpenAIRE |
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Nájsť tento článok vo Web of Science | Abstract: | Background Aim of this study is to examine pelvic floor symptoms, anatomical results and patients’ satisfaction after sacrospinous vaginal fixation for stage 4 pelvic organ prolapse. Methods All patients with stage 4 pelvic organ prolapse were treated with vaginal hysterectomy, native tissue cystocele and rectocele repair and bilateral sacrospinous vaginal fixation. Anatomical and functional outcomes according to the POPq classification system and the German version of the Australian pelvic floor questionnaire were assessed. Changes between baseline, first follow-up and second follow-up were assessed by the paired Wilcoxon rank test using R, version 3.5.1. Results 20 patients were included in the study. Scores in all four domains of the pelvic floor symptom questionnaire (bladder, bowel, prolapse, sexual function) were significantly improved at 6 and 12-months follow-up. One patient presented with a symptomatic stage 3 cystocele that needed a second surgical intervention and two patients needed surgery due to a de novo stress urinary incontinence. There were no perioperative adverse events and all patients reported full satisfaction after surgery. Conclusions The vaginal approach with hysterectomy, native tissue repair and bilateral sacrospinous vaginal fixation seems to be a safe and effective method for the treatment of advanced stage POP, offering excellent relief in all pelvic floor symptoms. Trial registration ClinicalTrials.gov (NCT 02998216), December 20th, 2016. Prospectively registered. |
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| ISSN: | 14712490 |
| DOI: | 10.1186/s12894-020-00694-3 |