Obesity and its long-term impact on sacrocolpopexy key outcomes (OBELISK)

Smazinka, Martin; Kališ, Vladimír; Havir, Martin; Havelková, Linda; Ismail, Khaled M.; Rušavý, Zdeněk

doi:10.1007/s00192-019-04076-8

Cited by 16 publications

(19 citation statements)

References 28 publications

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“…Surgical procedures were performed by one of four experienced urogynecological subspecialists. The surgical technique, sutures and mesh materials used were identical for all LSC variants and were similar to the previously published technique [28,29].…”

Section: Methodsmentioning

confidence: 99%

“…A 3D/4D transperineal ultrasound scans is also routinely performed at both follow-up appointments to assess the bladder neck and mesh positions. The ultrasound protocol has been previously published and is derived from the standardized assessment protocol suggested by Dietz et al [28,29,32]. Mesh placement is assessed based on a set of composite parameters including: distance of the lowest margin of the anterior mesh strand from the bladder neck < 20 mm [28,29]; shape of the mesh; absence of folding ; and a vertical mesh descent on Valsalva ≤ 20 mm.…”

Section: Methodsmentioning

confidence: 99%

“…Another reason for discrepancy in reported outcome rates between various studies is the POP-Q cut-off used to determine failure. Indeed, if we use the Ba > 0 cut-off for cystocele recurrence adopted in other studies [16,28], our anterior compartment failure rates would have dropped to zero.…”

Section: Summary Of Ndingsmentioning

confidence: 96%

“…Funders were not involved in the design, analysis or the reporting of this work. Finally, some of the procedures analyzed in this study contributed data to other studies that were designed to answer different research questions [28,29].…”

mentioning

confidence: 99%

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Pelvic organ prolapse and uterine preservation: A case control study (POP-UP study)

Gagyor

Kališ

Smazinka

et al. 2020

Preprint

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Background: Abdominal and laparoscopic sacro-colpopexy (LSC) is the preferred surgical option for the management of a symptomatic apical pelvic organ prolapse (POP). Women who have their uterus, and for whom an LSC is indicated, can have a laparoscopic sacro-hysteropexy (LSH), a laparoscopic supra-cervical hysterectomy and laparoscopic sacro-cervicopexy (LSCH+LSC) or a total laparoscopic hysterectomy and laparoscopic sacro-colpopexy (TLH+LSC). The main aim of this study was to compare clinical and patient reported outcomes of uterine sparing versus concomitant hysterectomy LSC procedures. Methods: A retrospective analysis of clinical, imaging and patient reported outcomes at baseline, 3 and 12 months after LSH (cases) versus either LSCH+LSC or TLH+LSC between January 2015 and January 2019 in a tertiary referral urogynecology center in Pilsen, the Czech Republic. Results. In total, 294 women were included in this analysis (LSH n = 43, LSCH+LSC n = 208 and TLH+LSC n = 43). There were no differences in the rates of perioperative injuries and complications. Operating time and blood loss were higher in the concomitant hysterectomy compared to the uterine sparing group but this was only significant when comparing LSH to TLH+LSC (p = 0.048). There were no statistically significant differences in any of the clinical or patient reported outcomes except for a significantly lower anterior compartment failure rate (p= 0.017) and higher optimal mesh placement rate at 12 months in women who had concomitant hysterectomy procedures (p = 0.006).Conclusion. LSH is associated with shorter operative time and intraoperative blood loss; nevertheless, higher rates of anterior compartment failures and suboptimal mesh placement.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Summary Of Ndingsmentioning

confidence: 96%

mentioning

confidence: 99%

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Pelvic organ prolapse and uterine preservation: A case control study (POP-UP study)

Gagyor

Kališ

Smazinka

et al. 2020

Preprint

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“…One in women undergo a form of reconstructive surgery for pelvic organ prolapse (POP) during the course of their life and this is expected to increase with the prolongation in life expectancy [1]. With improving operative safety and anaesthetic techniques, such surgical procedures are more frequently performed on perimenopausal and postmenopausal women [2][3][4][5]. Indeed, in a study by Kalis et al [6], 108 (89.3%) of 121 women undergoing laparoscopic sacrocolpopexy were > 50 years.…”

Section: Introductionmentioning

confidence: 99%

Pelvic Organ Prolapse and Uterine Preservation: A survey of female gynaecologists (POP-UP survey)

Urdzík

Kališ

Blaganje

et al. 2020

Preprint

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Backround: The aim of this study was to explore the personal views of female gynecologists regarding the management of POP with a particular focus on the issue of uterine sparing surgery. Methods: A questionnaire based survey of practicing female gynaecologists in the Czech Republic, Slovenia and Slovakia. Results : A total of 140 female gynaecologists from 81 units responded to our questionnaire. The majority of respondents stated they would rely on a urogynecologist to aid them with their choice of POP management options. The most preferred options for POP management were sacrocolpopexy and physiotherapy. Almost 2/3 of respondents opted for a hysterectomy together with POP surgery, if they were menopausal, even if the anatomical outcome was similar to uterine sparing POP surgery. Moreover, 81.4% of respondents, who initially opted for a uterine sparing procedure, changed their mind if the anatomical success of POP surgery with concomitant hysterectomy was superior. Discussing uterine cancer risk in relation to other organs had a less significant impact on their choices. Conclusions: The majority of female gynecologists in our study opted for hysterectomy if they were postmenopausal at the time of POP surgery. However, variation in information provision had an impact on their choice.

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Comparison of outcomes of laparoscopic sacrocolpopexy with concomitant supracervical hysterectomy or uterine preservation

et al. 2023

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Introduction and hypothesis Sacrocolpopexy was traditionally performed for post-hysterectomy prolapse or during concurrent hysterectomy. Sacrocolpopexy outcome with uterine preservation is poorly investigated. This study compared outcomes of laparoscopic sacrocolpopexy with concurrent supracervical hysterectomy or uterine preservation. Methods This retrospective study compared data of patients with pelvic organ prolapse who underwent laparoscopic sacrocolpopexy with uterine preservation with the data of controls who underwent laparoscopic sacrocolpopexy with supracervical hysterectomy. We analyzed composite failure in uterine preservation versus concurrent supracervical hysterectomy (primary objective) and evaluated factors associated with the primary outcome of composite failure after laparoscopic sacrocolpopexy with preservation or supracervical hysterectomy (secondary objective). Composite failure was defined as subjective bulge symptoms, reoperation, or anatomical prolapse. Cox models indicated time to composite failure as an endpoint. Results Of 274 patients, 232 underwent laparoscopic sacrocolpopexy with supracervical hysterectomy and 42 underwent laparoscopic uterine preservation. After propensity score matching (ratio: 2, for the laparoscopic sacrocolpopexy with supracervical hysterectomy group), 56 patients (24.1%) were in the supracervical hysterectomy group and 28 (66.7%) in the uterine preservation group. All patients underwent 24 months of follow-up. The composite failure rates were 10.7% for supracervical hysterectomy and 3.6% for preservation (p=0.87). The mean estimated blood loss was 10 ml (preservation, 10.0 ml [5.0–10.0] versus supracervical hysterectomy, 10.0 ml [10.0–15.0]; p=0.007). In the Cox proportional hazards model, higher preoperative body mass index and the point Ba increased composite failure risk. Conclusions Although not statistically significant, composite failure in the two techniques is likely clinically meaningful.

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Obesity and its long-term impact on sacrocolpopexy key outcomes (OBELISK)

Cited by 16 publications

References 28 publications

Pelvic organ prolapse and uterine preservation: A case control study (POP-UP study)

Pelvic organ prolapse and uterine preservation: A case control study (POP-UP study)

Pelvic Organ Prolapse and Uterine Preservation: A survey of female gynaecologists (POP-UP survey)

Comparison of outcomes of laparoscopic sacrocolpopexy with concomitant supracervical hysterectomy or uterine preservation

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