The effectiveness of surgical procedures to prevent post-hysterectomy pelvic organ prolapse: a systematic review of the literature.

Abstract

INTRODUCTION AND HYPOTHESIS:

Hysterectomy is one of the most commonly performed gynecological surgical procedures. One of the long-term risks associated with hysterectomy is the occurrence of pelvic organ prolapse (POP). To prevent post-hysterectomy POP, several suspension procedures are routinely performed at the time of hysterectomy. We performed a systematic review of published data in order to define the most effective surgical procedures for the prevention of post-hysterectomy POP.

METHODS:

We performed a systematic review of the literature by searching PubMed, the Cochrane Library, EMBASE, Ovid MEDLINE, and clinicaltrials.gov up to 24 May 2020. The search strategy included the keywords hysterectomy, post-hysterectomy, prolapse, colposuspension, culdoplasty, McCall, and combinations thereof. The inclusion criterion was a surgical procedure at the time of hysterectomy to prevent de novo POP. The outcome was incidence of post-hysterectomy POP.

RESULTS:

Six out of 553 retrieved studies met the methodological criteria for complete analysis. In this review, 719 women aged over 18 years were included. Only 2 studies were designed as prospective trials; however, only 1 compared women undergoing a procedure at the time of hysterectomy with controls. The prevalence of post-hysterectomy prolapse varied from 0% to 39%.

CONCLUSION:

A systematic review of published literature suggests that performing variations of McCall culdoplasty at the time of hysterectomy might be the most effective prophylactic surgical procedure for preventing post-hysterectomy pelvic organ prolapse.

• Authors: Greta Lisa Carlin, Barbara Bodner-Adler, Heinrich Husslein, Magdalena Ritter, Wolfgang Umek
• Journal: International urogynecology journal (Int Urogynecol J) Vol. 32 Issue 4 Pg. 775-783 (Apr 2021) ISSN: 1433-3023 [Electronic] England
• PMID: 33150453 (Publication Type: Journal Article, Review, Systematic Review)

Topics

• Adult
• Female
• Gynecologic Surgical Procedures (adverse effects)
• Humans
• Hysterectomy (adverse effects)
• Middle Aged
• Pelvic Organ Prolapse (etiology, prevention & control, surgery)
• Prospective Studies
• Treatment Outcome