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A multicenter, prospective trial to evaluate mesh-augmented sacrospinous hysteropexy for uterovaginal prolapse

INTRODUCTION AND HYPOTHESIS: Hysterectomy is often part of pelvic organ prolapse repair. However, this may offer no benefit when compared to uterine preservation. We aimed to prospectively evaluate a minimally invasive bilateral sacrospinous hysteropexy using polypropylene mesh. We hypothesized that...

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Autores principales: Jirschele, K., Seitz, M., Zhou, Y., Rosenblatt, P., Culligan, P., Sand, P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer London 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4544494/
https://www.ncbi.nlm.nih.gov/pubmed/25394892
http://dx.doi.org/10.1007/s00192-014-2564-x
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author Jirschele, K.
Seitz, M.
Zhou, Y.
Rosenblatt, P.
Culligan, P.
Sand, P.
author_facet Jirschele, K.
Seitz, M.
Zhou, Y.
Rosenblatt, P.
Culligan, P.
Sand, P.
author_sort Jirschele, K.
collection PubMed
description INTRODUCTION AND HYPOTHESIS: Hysterectomy is often part of pelvic organ prolapse repair. However, this may offer no benefit when compared to uterine preservation. We aimed to prospectively evaluate a minimally invasive bilateral sacrospinous hysteropexy using polypropylene mesh. We hypothesized that anatomic success and patient satisfaction can be achieved with this technique. METHODS: Women with uterovaginal prolapse desiring surgery who had completed childbearing were enrolled. Preoperative assessment included standardized prolapse examination and validated symptom and pain scale questionnaires. Women with prior pelvic organ prolapse repair or any contraindication to uterine preservation were excluded. Data including demographic, operative and postoperative information was collected on patients for 1 year following surgery. Continuous variables are summarized as means (standard deviation) and categorical variables are summarized as frequencies and percentages. A mixed-effects model was used to evaluate the changes in questionnaire scores and outcomes at 6 months and 12 months after surgery with random effects accounting for the center effect with adjustment for age. RESULTS: The study group comprised 99 women from three female pelvic medicine and reconstructive surgery (urogynecology) centers. The average age of the participants was 67.0 years (11.32 years), BMI 26.04 kg/m(2) (3.56 kg/m(2)), and the majority were multiparous (98.9 %) and menopausal (90.9 %). Overall success at 12 months, as measured by composite outcome was 97.7 % (with the Ba point as the anatomic landmark) and 96.6 % (with the C point as the anatomic landmark). The overall exposure rate was 6.52 % and reoperation rate was 7.53 %. All subjective questionnaire scores and anatomic outcomes had improved at 12 months. CONCLUSIONS: Sacrospinous hysteropexy using a minimally invasive polypropylene mesh kit is an effective and safe technique for addressing uterovaginal prolapse as an alternative to hysterectomy at the time of pelvic reconstructive surgery.
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spelling pubmed-45444942015-08-25 A multicenter, prospective trial to evaluate mesh-augmented sacrospinous hysteropexy for uterovaginal prolapse Jirschele, K. Seitz, M. Zhou, Y. Rosenblatt, P. Culligan, P. Sand, P. Int Urogynecol J Original Article INTRODUCTION AND HYPOTHESIS: Hysterectomy is often part of pelvic organ prolapse repair. However, this may offer no benefit when compared to uterine preservation. We aimed to prospectively evaluate a minimally invasive bilateral sacrospinous hysteropexy using polypropylene mesh. We hypothesized that anatomic success and patient satisfaction can be achieved with this technique. METHODS: Women with uterovaginal prolapse desiring surgery who had completed childbearing were enrolled. Preoperative assessment included standardized prolapse examination and validated symptom and pain scale questionnaires. Women with prior pelvic organ prolapse repair or any contraindication to uterine preservation were excluded. Data including demographic, operative and postoperative information was collected on patients for 1 year following surgery. Continuous variables are summarized as means (standard deviation) and categorical variables are summarized as frequencies and percentages. A mixed-effects model was used to evaluate the changes in questionnaire scores and outcomes at 6 months and 12 months after surgery with random effects accounting for the center effect with adjustment for age. RESULTS: The study group comprised 99 women from three female pelvic medicine and reconstructive surgery (urogynecology) centers. The average age of the participants was 67.0 years (11.32 years), BMI 26.04 kg/m(2) (3.56 kg/m(2)), and the majority were multiparous (98.9 %) and menopausal (90.9 %). Overall success at 12 months, as measured by composite outcome was 97.7 % (with the Ba point as the anatomic landmark) and 96.6 % (with the C point as the anatomic landmark). The overall exposure rate was 6.52 % and reoperation rate was 7.53 %. All subjective questionnaire scores and anatomic outcomes had improved at 12 months. CONCLUSIONS: Sacrospinous hysteropexy using a minimally invasive polypropylene mesh kit is an effective and safe technique for addressing uterovaginal prolapse as an alternative to hysterectomy at the time of pelvic reconstructive surgery. Springer London 2014-11-14 2015 /pmc/articles/PMC4544494/ /pubmed/25394892 http://dx.doi.org/10.1007/s00192-014-2564-x Text en © The Author(s) 2014 https://creativecommons.org/licenses/by/4.0/ Open Access This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.
spellingShingle Original Article
Jirschele, K.
Seitz, M.
Zhou, Y.
Rosenblatt, P.
Culligan, P.
Sand, P.
A multicenter, prospective trial to evaluate mesh-augmented sacrospinous hysteropexy for uterovaginal prolapse
title A multicenter, prospective trial to evaluate mesh-augmented sacrospinous hysteropexy for uterovaginal prolapse
title_full A multicenter, prospective trial to evaluate mesh-augmented sacrospinous hysteropexy for uterovaginal prolapse
title_fullStr A multicenter, prospective trial to evaluate mesh-augmented sacrospinous hysteropexy for uterovaginal prolapse
title_full_unstemmed A multicenter, prospective trial to evaluate mesh-augmented sacrospinous hysteropexy for uterovaginal prolapse
title_short A multicenter, prospective trial to evaluate mesh-augmented sacrospinous hysteropexy for uterovaginal prolapse
title_sort multicenter, prospective trial to evaluate mesh-augmented sacrospinous hysteropexy for uterovaginal prolapse
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4544494/
https://www.ncbi.nlm.nih.gov/pubmed/25394892
http://dx.doi.org/10.1007/s00192-014-2564-x
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