Long‐term outcome of native tissue reconstructive vaginal surgery for advanced pelvic organ prolapse at 86 months: Hysterectomy versus hysteropexy

Lo, Tsia‐Shu; Pue, Leng Boi; Hung, Tai-Ho; Wu, Pei‐Ying; Tan, Yiap Loong

doi:10.1111/jog.12678

Cited by 31 publications

(29 citation statements)

References 32 publications

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“…However, uterine preservation has become more prevalent according to its noninferior outcomes based on current evidence. Shorter operation times, less blood loss, better recovery, and lower complication rates have been reported previously 4,7,15,16 . Hefni et al found comparable recurrence rates and reoperation rates between SSH and SSC 17 .…”

Section: Discussionmentioning

confidence: 87%

“…Hefni et al found comparable recurrence rates and reoperation rates between SSH and SSC 17 . Lo et al also found no difference in the objective cure rate after adjusting for age, parity, and postmenopausal status either 4 . There are some studies comparing SSH with other procedures with concomitant VH.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, hysterectomy is not routinely necessary in pelvic reconstruction surgery, 13,14 but it is still often performed. Shorter operation times, less intraoperative blood loss, fewer complications, and similar success rates have been reported for uterine preservation in POP surgery compared with concomitant hysterectomy 4,7,15,16 . In this study, we aimed to evaluate the efficacy of SSLF in patients with and without hysterectomy and to determine whether the anatomical recurrence rate is lower with uterine preservation.…”

Section: Introductionmentioning

confidence: 91%

“…SSLF can proceed transvaginally or abdominally and unilaterally or bilaterally. Its recurrence rate varies from 11.4% to 59.7% with different definitions and follow‐up durations, and the retreatment rate is 1.4% to 8.7% 4‐9 . Two multicenter randomized controlled trials (RCTs) demonstrated that the success rates of SSLF in the apical compartment were comparable to those of TVM 10,11 .…”

Section: Introductionmentioning

confidence: 99%

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Sacrospinous ligament fixation with uterine preservation reduces the risk of anatomical recurrence in pelvic organ prolapse

Chou

Chuang

Kung

et al. 2020

LUTS

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Objectives This study investigated the effectiveness of sacrospinous ligament fixation (SSLF) and whether uterine preservation reduces the anatomical recurrence rate. Methods The medical records of 82 patients who received SSLF in a single medical center were reviewed retrospectively. Anatomical recurrence was defined as Pelvic Organ Prolapse‐Quantification stage 2 or higher in any compartment. The primary outcome was intergroup analysis for uterine preservation and concomitant hysterectomy patients. The secondary outcomes were anatomical recurrence risk factors and the incidence of adverse events. Propensity score matching (PSM) was used to adjust for demographic differences between groups. Results The anatomical recurrence rate was 19.5%, and the retreatment rate was 11.0% (mean follow‐up duration: 22.9 months). Cystocele was the most common recurrent compartment (17.1%). The uterine preservation group (n = 66) was younger, had lower parity, and had fewer stage 3 to 4 cystoceles and uterine prolapses than the concomitant hysterectomy group (n = 16). Shorter operation times (99.4 minutes vs 153.7 minutes, P = .002) and lower anatomical recurrence rates (11.5% vs 45.5%, P = .039) were found in the uterine preservation group before and after PSM. Previous pelvic organ prolapse surgery (hazard ratio 3.14) and concomitant hysterectomy (hazard ratio 4.08) were identified as risk factors for anatomical recurrence. The most common adverse event was buttock pain (14.6%), which resolved spontaneously within 4 weeks. Conclusions SSLF is an effective surgical method using native tissue for pelvic reconstruction. Compared with concomitant hysterectomy, SSLF with uterine preservation reduces the anatomical recurrence rate.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Sacrospinous ligament fixation with uterine preservation reduces the risk of anatomical recurrence in pelvic organ prolapse

Chou

Chuang

Kung

et al. 2020

LUTS

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“…Surgery was considered to be the most effective and durable treatment, which includes autologous tissue repair and synthetic mesh implantation. In general, autologous tissue repair showed good integration within host tissues, a minimal to moderate inflammatory response, and a moderate degree of collagen production and underwent a degree of remodeling over the long term, but a high recurrence rate ( Gigliobianco et al, 2015 ; Lo et al, 2015 ). Polypropylene patches are the most used synthetic meshes in implantation surgery, which offer several advantages including lack of transmission of infectious diseases, ease of availability, sustainable tensile strength, and good mechanical properties.…”

Section: Introductionmentioning

confidence: 99%

Tissue-engineered repair material for pelvic floor dysfunction

Lin

Liu

Chen

2022

Front. Bioeng. Biotechnol.

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Pelvic floor dysfunction (PFD) is a highly prevalent urogynecology disorder affecting many women worldwide, with symptoms including pelvic organ prolapse (POP), stress urinary incontinence (SUI), fecal incontinence, and overactive bladder syndrome (OAB). At present, the clinical treatments of PFD are still conservative and symptom-based, including non-surgical treatment and surgery. Surgical repair is an effective and durable treatment for PFD, and synthetic and biological materials can be used to enforce or reinforce the diseased tissue. However, synthetic materials such as polypropylene patches caused a series of complications such as mesh erosion, exposure, pain, and inflammation. The poor mechanical properties and high degradation speed of the biomaterial meshes resulted in poor anatomical reduction effect and limitation to clinical application. Therefore, the current treatment options are suboptimal. Recently, tissue-engineered repair material (TERM) has been applied to repair PFD and could markedly improve the prognosis of POP and SUI repair surgery in animal models. We review the directions and progression of TERM in POP and SUI repair. Adipose-derived stem cells (ADSCs) and endometrial mesenchymal stem cells (eMSCs) appear to be suitable cell types for scaffold seeding and clinical implantation. The multidisciplinary therapy approach to tissue engineering is a promising direction for tissue repair. More and longer follow-up studies are needed before determining cell types and materials for PFD repair.

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Results of sacrospinous ligament fixation using conventional instruments for symptomatic stage 2 and 3 apical prolapse over 3 years

Ren

Zhang

Tian

et al. 2023

Intl J Gynecology & Obste

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Objective To evaluate the long‐term efficacy and quality of life concerning sacrospinous ligament fixation (SSLF) using conventional instruments for Chinese women with symptomatic stage 2 and 3 apical prolapse. Methods This single‐arm prospective cohort study was conducted at our hospital between October 2011 and December 2018. Eligible participants were followed up over 3 years after surgery. The primary surgical outcome was composite surgical failure. Secondary outcomes included rate of satisfaction, quality of life (QoL) scores, and long‐term complications. Results Fifty‐nine patients were enrolled (mean age 57.1 years), of whom 55 (93.22%) completed the 3‐year follow up. At year 3, the composite failure rate was 21.34% (95% confidence interval [CI] 9.30%–31.79%), and satisfaction rate was 81.40% (95% CI 66.09%–91.08%). Right thigh pain and de novo dyspareunia occurred in 1.8% and 14.6% patients after year 1, respectively, but at year 3 there were no complications. Lower urinary tract symptoms were present in 5.5% of patients. Improvement was found in urinary symptoms and prolapse symptoms, but sexual function showed no significant change. Conclusions Compared with results at year 1, complication rates of SSLF decreased at year 3. The composite failure rate was relatively low and satisfaction rate was relatively high at year 3. Prolapse and urinary symptoms improved significantly after surgery.

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Long‐term outcome of native tissue reconstructive vaginal surgery for advanced pelvic organ prolapse at 86 months: Hysterectomy versus hysteropexy

Cited by 31 publications

References 32 publications

Sacrospinous ligament fixation with uterine preservation reduces the risk of anatomical recurrence in pelvic organ prolapse

Sacrospinous ligament fixation with uterine preservation reduces the risk of anatomical recurrence in pelvic organ prolapse

Tissue-engineered repair material for pelvic floor dysfunction

Results of sacrospinous ligament fixation using conventional instruments for symptomatic stage 2 and 3 apical prolapse over 3 years

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