Anterior Wall Success at 1 Year After Vaginal Uterosacral Ligament Suspension and Sacral Colpopexy

Abstract

Objectives The primary objective was to evaluate 1-year anterior wall anatomic success rates for vaginal uterosacral ligament suspension (USLS) and minimally invasive sacral colpopexy (SCP) using delayed-absorbable suture. Secondary objectives included assessment of apical success, mesh or suture exposure, and postoperative quality of life (QoL) measures 12 months after surgery. Methods This was a retrospective cohort study including women who underwent a hysterectomy with concomitant USLS or SCP with delayed-absorbable suture from January 2011 to December 2015 with 1-year follow-up. Successful anterior vaginal wall support was defined as Ba of less than 0. Successful apical support was defined as no apical descent (point C) greater than one half of the total vaginal length. In addition, 1-year QoL questionnaires were measured postoperatively. Results A total of 282 women were identified. Sixty-two women (31 vaginal USLS and 31 SCP) met inclusion criteria. Demographics were similar between groups except for a higher body mass index in the USLS group (27.5 ± 5.6 kg/m2 vs 24.1 ± 3.3 kg/m2, P < 0.05). Preoperative POP-Q was mostly stage II and III. At 1-year, anatomic success rates for the anterior compartment were 66.7% versus 90.3% for USLS and SCP groups, respectively (P = 0.02). There was no significant difference in apical success (P = 1.00) or QoL scores between groups at 1 year. Conclusions Anatomic success rates at 1 year using delayed-absorbable suture were better for SCP when using the anterior wall as a measure of success, but there were no significant differences in apical success rates, mesh or suture exposure, and QoL measures between groups.

Abdominal and vaginal pelvic support with concomitant hysterectomy for uterovaginal pelvic prolapse: a comparative systematic review and meta-analysis

“…A total of 4225 studies were initially identified. Only four papers were included, three of which were a retrospective study design [19][20][21], and one was a randomized clinical trial (RCT) [23]. The screening, selection, and final inclusion criteria are presented in the flowchart (Fig.…”

“…Subjective outcomes were measured differently in the included studies. PFDI-20 was used in three studies; therefore, it was the only measure for subjective improvement [19][20][21]. The Pelvic Floor Impact Questionnaire-Short Form (PFIQ-7) and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) were used in two studies [20,21].…”

“…PFDI-20 was used in three studies; therefore, it was the only measure for subjective improvement [19][20][21]. The Pelvic Floor Impact Questionnaire-Short Form (PFIQ-7) and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) were used in two studies [20,21]. International Consultation on Incontinence Modular Questionnaire (ICIQ) was used in one study [23].…”

“…International Consultation on Incontinence Modular Questionnaire (ICIQ) was used in one study [23]. Surgical and non-surgical retreatment was not used as an assessment of failure since it was reported only in two studies [21,23]. Compartmental recurrence rates were analyzed utilizing the number of events and the total number of patients in each study arm, where odds ratios and their 95% confidence intervals were generated.…”

“…Three of the included studies [19][20][21] were retrospective cohorts and were evaluated utilizing the Newcastle-Ottawa quality assessment scale [22]. Cochrane risk-of-bias tool was used for the fourth randomized control trial study [23,24].…”