Cargando…
Sacrospinous Hysteropexy Versus Prolapse Hysterectomy with Apical Fixation: A Retrospective Comparison over an 18 Year Period
Background. Pelvic organ prolapse (POP) is a common health problem, with a high lifetime risk for prolapse surgery. Uterine-preserving procedures such as vaginal sacrospinous hysteropexy (SSH) have become an increasingly utilized surgical option for the primary treatment of POP. We wanted to evaluat...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10059856/ https://www.ncbi.nlm.nih.gov/pubmed/36983178 http://dx.doi.org/10.3390/jcm12062176 |
_version_ | 1785016975128264704 |
---|---|
author | Carlin, Greta Lisa Lange, Sören Ziegler, Christina Heinzl, Florian Bodner-Adler, Barbara |
author_facet | Carlin, Greta Lisa Lange, Sören Ziegler, Christina Heinzl, Florian Bodner-Adler, Barbara |
author_sort | Carlin, Greta Lisa |
collection | PubMed |
description | Background. Pelvic organ prolapse (POP) is a common health problem, with a high lifetime risk for prolapse surgery. Uterine-preserving procedures such as vaginal sacrospinous hysteropexy (SSH) have become an increasingly utilized surgical option for the primary treatment of POP. We wanted to evaluate peri- and postoperative outcome parameters of SSH as an alternative to vaginal hysterectomy with apical fixation. Methods. A retrospective cohort study was conducted (2003–2021). All patients who underwent primary SSH (study group) for symptomatic POP were matched 1:1 by age and BMI with patients who underwent primary prolapse hysterectomy with apical fixation (control group). Results. A total of 192 patients were included with 96 patients in the each of the SSH and hysterectomy groups. There were no statistically significant differences in baseline characteristics. The SSH group show a significantly shorter mean surgery time (p < 0.001), significantly fewer hospitalization days (p < 0.001), and significantly less intraoperative blood loss (p = 0.033) in comparison to the control group. Neither group had any intraoperative complication, or an intraoperative conversion to other surgical management options. No statistically significant difference was found in postoperative complications as categorized by the Clavien–Dindo classification or in postoperative urogynecological issues (UTI, de-novo, incontinence, residual urine, voiding disorders). Through log regression, none of the confounding factors such as age, BMI, or preoperative POP-Q stage could be identified as independent risk factors for the occurrence of postoperative complications. Conclusions. Our results confirm that a uterus-preserving technique has many benefits and, thus, should be considered as an additional intermediate step in a long-term treatment plan of pelvic organ prolapse. |
format | Online Article Text |
id | pubmed-10059856 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-100598562023-03-30 Sacrospinous Hysteropexy Versus Prolapse Hysterectomy with Apical Fixation: A Retrospective Comparison over an 18 Year Period Carlin, Greta Lisa Lange, Sören Ziegler, Christina Heinzl, Florian Bodner-Adler, Barbara J Clin Med Article Background. Pelvic organ prolapse (POP) is a common health problem, with a high lifetime risk for prolapse surgery. Uterine-preserving procedures such as vaginal sacrospinous hysteropexy (SSH) have become an increasingly utilized surgical option for the primary treatment of POP. We wanted to evaluate peri- and postoperative outcome parameters of SSH as an alternative to vaginal hysterectomy with apical fixation. Methods. A retrospective cohort study was conducted (2003–2021). All patients who underwent primary SSH (study group) for symptomatic POP were matched 1:1 by age and BMI with patients who underwent primary prolapse hysterectomy with apical fixation (control group). Results. A total of 192 patients were included with 96 patients in the each of the SSH and hysterectomy groups. There were no statistically significant differences in baseline characteristics. The SSH group show a significantly shorter mean surgery time (p < 0.001), significantly fewer hospitalization days (p < 0.001), and significantly less intraoperative blood loss (p = 0.033) in comparison to the control group. Neither group had any intraoperative complication, or an intraoperative conversion to other surgical management options. No statistically significant difference was found in postoperative complications as categorized by the Clavien–Dindo classification or in postoperative urogynecological issues (UTI, de-novo, incontinence, residual urine, voiding disorders). Through log regression, none of the confounding factors such as age, BMI, or preoperative POP-Q stage could be identified as independent risk factors for the occurrence of postoperative complications. Conclusions. Our results confirm that a uterus-preserving technique has many benefits and, thus, should be considered as an additional intermediate step in a long-term treatment plan of pelvic organ prolapse. MDPI 2023-03-10 /pmc/articles/PMC10059856/ /pubmed/36983178 http://dx.doi.org/10.3390/jcm12062176 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Carlin, Greta Lisa Lange, Sören Ziegler, Christina Heinzl, Florian Bodner-Adler, Barbara Sacrospinous Hysteropexy Versus Prolapse Hysterectomy with Apical Fixation: A Retrospective Comparison over an 18 Year Period |
title | Sacrospinous Hysteropexy Versus Prolapse Hysterectomy with Apical Fixation: A Retrospective Comparison over an 18 Year Period |
title_full | Sacrospinous Hysteropexy Versus Prolapse Hysterectomy with Apical Fixation: A Retrospective Comparison over an 18 Year Period |
title_fullStr | Sacrospinous Hysteropexy Versus Prolapse Hysterectomy with Apical Fixation: A Retrospective Comparison over an 18 Year Period |
title_full_unstemmed | Sacrospinous Hysteropexy Versus Prolapse Hysterectomy with Apical Fixation: A Retrospective Comparison over an 18 Year Period |
title_short | Sacrospinous Hysteropexy Versus Prolapse Hysterectomy with Apical Fixation: A Retrospective Comparison over an 18 Year Period |
title_sort | sacrospinous hysteropexy versus prolapse hysterectomy with apical fixation: a retrospective comparison over an 18 year period |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10059856/ https://www.ncbi.nlm.nih.gov/pubmed/36983178 http://dx.doi.org/10.3390/jcm12062176 |
work_keys_str_mv | AT carlingretalisa sacrospinoushysteropexyversusprolapsehysterectomywithapicalfixationaretrospectivecomparisonoveran18yearperiod AT langesoren sacrospinoushysteropexyversusprolapsehysterectomywithapicalfixationaretrospectivecomparisonoveran18yearperiod AT zieglerchristina sacrospinoushysteropexyversusprolapsehysterectomywithapicalfixationaretrospectivecomparisonoveran18yearperiod AT heinzlflorian sacrospinoushysteropexyversusprolapsehysterectomywithapicalfixationaretrospectivecomparisonoveran18yearperiod AT bodneradlerbarbara sacrospinoushysteropexyversusprolapsehysterectomywithapicalfixationaretrospectivecomparisonoveran18yearperiod |