New procedures for uterine prolapse

Khunda, Azar; Vashisht, Arvind; Cutner, Alfred

doi:10.1016/j.bpobgyn.2012.12.004

Cited by 21 publications

(11 citation statements)

References 96 publications

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“…The advantages and effectiveness of the procedure in the long‐term warrant need to be further assessed. It had been reported that women have became pregnant and delivered successfully after LSH, so we also hope to follow up women who conceived after operation, and to understand the relation between the procedure and the pregnancy and delivery.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic extraperitoneal uterine suspension with suture line instead of mesh

Liang

Chen

Deng

et al. 2017

BJOG

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Objective To compare the safety and effectiveness of two different materials (mesh and suture line) used in laparoscopic extraperitoneal uterine suspension.Design A retrospective observational study.Setting Gynaecology departments in two hospitals in China.Population Women with symptomatic pelvic organ prolapse (POP) of stage II or higher.Methods The women were divided into two groups according to the two different materials for laparoscopic extraperitoneal uterine suspension: mesh or suture line. The baseline characteristics, perioperative details, complications, objective and subjective indexes of the two groups were compared.Main outcome measures The primary outcome was subjective satisfaction rate based upon validated questionnaires. The secondary outcome was objective anatomic assessment with the POP-Q system.Results No difference was found in baseline characteristics and perioperative details except that there were more cases of cardiovascular disease (CVD) and associated other surgeries in the Line than the Mesh group (36 versus 19, P < 0.05; 12 versus 2, P < 0.05). Statistically significant improvements were found in anatomical measures of points Aa, Ba, Ap, Bp, C and TVL (P < 0.01), as well as functional and quality-of-life measures (P < 0.01 for PFDI-20 and PFIQ-7) between both groups. The postoperative PFDI-20, PFIQ-7 and PGI-I scores were not different between two groups (P > 0.05). Two cases of deep wound infection were observed in Mesh group at 3-month follow up.Conclusions Laparoscopic extraperitoneal linear uterine suspension is easy to perform and is associated with fewer meshrelated complications. It is more secure, especially in elderly women and in those with physical complications.Keywords Laparoscopic, mesh, uterine prolapse, uterine suspension.Tweetable abstract Laparoscopic extraperitoneal linear uterine suspension is safe, with fewer mesh-related complications.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic extraperitoneal uterine suspension with suture line instead of mesh

Liang

Chen

Deng

et al. 2017

BJOG

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“…A recent review [1] reported that the highest rates of reoperation for pelvic-floor disorders occurred in women undergoing surgery for apical defects (33% reoperation). Hysterectomy alone will often fail to address the underlying deficiencies in pelvic support.…”

Section: Introductionmentioning

confidence: 99%

A review on the role of laparoscopic sacrocervicopexy

Rosati

Bramante

Conti

2014

Current Opinion in Obstetrics &Amp; Gynecology

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“…15 Recently, more and more novel surgical approaches make uterine preservation more feasible during pelvic reconstructive surgery. 10,11 Several surgical approaches have been developed via the routes of vaginal, abdominal, laparoscopic, or robotic-assisted procedures, e.g., sacral hysteropexy, 16 uterosacral hysteropexy, 17 sacrospinous hysteropexy, 18 and vaginal mesh hysteropexy. 19,20 In the Gutman and Maher 6 review, sacrospinous hysteropexy (87%, 373/428) is as effective as vaginal hysterectomy and repair (93%, 242/262) in retrospective comparative studies and in a meta-analysis with reduced operating time, blood loss, and recovery time.…”

Section: Discussionmentioning

confidence: 99%

“…9 Today, more uterus-preserving procedures are used to treat POP; uterine preservation is now feasible during pelvic reconstructive surgeries. 10,11 After our initial observation of an increasing use of hysteropexy with uterine preservation in treating uterine prolapse, we further explored the reoperation rates and the variables of surgical type, either hysterectomy or hysteropexy, for the failed primary surgery for uterine prolapse; also, we tried to identify the variables of the choices of repeat hysteropexy among the failed hysteropexies, based on the National Health Insurance (NHI) claims data.…”

Section: Introductionmentioning

confidence: 99%

The choice of reoperation after primary surgeries for uterine prolapse: A nationwide study

Weng

2015

Gynecology and Minimally Invasive Therapy

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a b s t r a c tObjective: Our previous study described the increasing adoption of uterine-preserving procedures in the surgical approach for uterine prolapse. In this follow-up study, we further explored the reoperation rate and variables for the choice of surgeries after primary uterine prolapse surgery, based on the nationwide claim data in Taiwan. Materials and methods: The data of this study was obtained from the Inpatient Expenditures by Admission files of the National Health Insurance Research Database (NHIRD). Women who received primary and repeat surgeries, either hysteropexy or hysterectomy, were identified between 1997 and 2010; and followed up to 2010 or till the event of reoperation. We analyzed the variables including the primary surgical type, concomitant stress urinary incontinence (SUI) surgery, patient age, surgeon age, and hospital accreditation level. Results: Among the total 36,609 women, a higher reoperation rate was noted in the hysteropexy group (156/4095) (3.81%) than in the hysterectomy group (116/32,514) (0.36%); the adjusted odds ratio (OR) was 11.70 [95% confidence interval (CI): 8.86e15.43]. It was lower in patients with concomitant SUI surgery; older patients (aged 60 years and 40e69 years vs. < 40 years); older surgeons (aged 50 years and 40e49 years vs. < 40 years), but not significant in hospital levels. Hysterectomy was the preferred choice as compared with repeat hysteropexy (69.87% vs. 30.13%) among the failed hysteropexy group. All variables for the choice of repeat hysteropexy were not significant. Conclusion: Our study offers a population-based nationwide observation that hysteropexy correlates with a higher reoperation rate, as compared with hysterectomy; but it is still as high as 30% in the surgical choice of the failed hysteropexy group.

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New procedures for uterine prolapse

Cited by 21 publications

References 96 publications

Laparoscopic extraperitoneal uterine suspension with suture line instead of mesh

Laparoscopic extraperitoneal uterine suspension with suture line instead of mesh

A review on the role of laparoscopic sacrocervicopexy

The choice of reoperation after primary surgeries for uterine prolapse: A nationwide study

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