Hysteropexy compared to hysterectomy for uterine prolapse surgery: does durability differ?

Abstract

INTRODUCTION AND HYPOTHESIS:

The aim of this study is to assess the impact of hysterectomy on durability of uterine prolapse repair by comparing hysterectomy/uterosacral cuff suspension (VH) to a new vaginal uterosacral hysteropexy (USH).

METHODS:

A retrospective chart review of uterine prolapse patients after USH or VH with concomitant procedures as indicated was conducted, analyzing Baden-Walker grading of apex, anterior, and posterior compartments (Kaplan-Meier analysis) Baden et al. (Tex Med 64(5):56-58, 1968).

RESULTS:

A total of 200 charts met criteria. USH women weighed less, were younger, and more constipated with larger rectoceles. Levator parameters did not differ Romanzi et al. (Neurourol Urodyn 18(6):603-612, 1999). Baden-Walker data were entered at recurrence or minimum of 6 months (2.4 months-10 years; median, 1.5 years). All-apex durability was 96.4%, with no difference between hysteropexy and cuff suspension (96.0% vs. 96.8%, p = 0.90), cystocele (86.8% vs. 93.8%, p = 0.31), or rectocele (97.8% vs. 100%, p = 0.16) at 2 years.

CONCLUSION:

In uterine prolapse patients, technically similar uterosacral hysteropexy durability did not differ from hysterectomy-based cuff suspension nor between cohorts for cystocele or rectocele.

• Authors: Lauri J Romanzi, Renuka Tyagi
• Journal: International urogynecology journal (Int Urogynecol J) Vol. 23 Issue 5 Pg. 625-31 (May 2012) ISSN: 1433-3023 [Electronic] England
• PMID: 22310923 (Publication Type: Comparative Study, Journal Article)

Topics

• Adult
• Aged
• Biomechanical Phenomena
• Female
• Gynecologic Surgical Procedures (methods)
• Humans
• Hysterectomy (methods)
• Kaplan-Meier Estimate
• Longitudinal Studies
• Middle Aged
• Retrospective Studies
• Surgical Mesh
• Treatment Outcome
• Uterine Prolapse (surgery)