Pelvic organ prolapse surgery after prophylactic vaginal vault suspension during hysterectomy – An observational follow-up study

2019 ◽  
Vol 234 ◽  
pp. e125
Author(s):  
Lisbeth Bonde ◽  
Lauge Østergaard ◽  
Emil Fosbøl ◽  
Lars Møller ◽  
Bent Ottesen ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Pelvic Organ ◽  
Vaginal Vault ◽  
Prolapse Surgery ◽  
Vaginal Vault Suspension ◽  
Follow Up Study ◽  
Pelvic Organ Prolapse Surgery ◽  
Vault Suspension

scholarly journals Utilization and perioperative outcomes of robotic vaginal vault suspension compared to abdominal or vaginal approaches for pelvic organ prolapse

2014 ◽  
Vol 8 (3-4) ◽  
pp. 100 ◽  
Author(s):  
Akshay Sood ◽  
Hanhan Li ◽  
Jesse Sammon ◽  
Florian Roghmann ◽  
Michael Ehlert ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Length Of Stay ◽  
Intraoperative Complications ◽  
Pelvic Organ ◽  
Vaginal Vault ◽  
Hospital Charges ◽  
Perioperative Outcomes ◽  
Vaginal Vault Suspension ◽  
Prolonged Length ◽  
Vault Suspension

Objectives: Robot-assisted vaginal vault suspension (RAVVS) for pelvic organ prolapse (POP) represents a minimally-invasive alternative to abdominal sacrocolpopexy. We measured perioperative outcomes and utilization rates of RAVVS.Methods: RAVVS (n = 2381) and open VVS (OVVS, n = 11080) data were extracted from the 2009-2010 Nationwide Inpatient Sample. Propensity score-matched analysis compared patients undergoing RAVVS or OVVS for complications, mortality, prolonged length-of-stay, and elevated hospital charges.Results: Use of RAVVS for POP increased from 2009 to 2010 (16.3% to 19.2%). Patients undergoing RAVVS were more likely to be white (77.2% vs. 69.6%), to carry private insurance (52.8% vs. 46.0%) and to have fewer comorbidities (Charlson Comorbidity Index [CCI] ≥1 = 17.5% vs. 26.6%). They were more likely to undergo surgery at urban (98.2% vs. 93.7%) and academic centres (75.7% vs. 56.7%). Patients undergoing RAVVS were less likely to receive a blood-transfusion (0.7% vs. 1.8%, p < 0.001) or experience prolonged length-of-stay (9.3% vs. 25.1%, p < 0.001). They had more intraoperative complications (6.0% vs. 4.2%, p < 0.001), and higher median hospital charges ($32 402 vs. $24 136, p < 0.001). Overall postoperative complications were equivalent (17.9%, p = 1.0), though there were differences in wound (0.4% vs. 1.3%, p < 0.001), genitourinary (4.9% vs. 6.5%, p = 0.009), and surgical (6.6% vs. 4.9%, p = 0.007) complications.Conclusions: The increasing use of RAVVS from 2009 to 2010 suggests a growth in the adoption of robotics to manage POP. We show that RAVVS is associated with decreased length of stay, fewer blood transfusions, as well as lower postoperative wound, genitourinary and vascular complications. The benefits of RAVVS are mitigated by higher hospital charges and higher rates of intraoperative complications.

scholarly journals Protocol for a prospective multisite cohort study investigating hysterectomy versus uterine preservation for pelvic organ prolapse surgery: the HUPPS study

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e053679
Author(s):  
Natalie V Scime ◽  
Kaylee Ramage ◽  
Erin A Brennand
Keyword(s):  
Cohort Study ◽  
Pelvic Organ Prolapse ◽  
Pelvic Organ ◽  
Vaginal Vault ◽  
Service Utilisation ◽  
Uterine Preservation ◽  
Subjective Report ◽  
Vaginal Vault Suspension ◽  
Pop Surgery ◽  
Vault Suspension

IntroductionPelvic organ prolapse (POP) is the descent of pelvic organs into the vagina resulting in bulge symptoms and occurs in approximately 50% of women. Almost 20% of women will elect surgical correction of this condition by age 85. Removal of the uterus (hysterectomy) with concomitant vaginal vault suspension is a long-standing practice in POP surgery to address apical (uterine) prolapse. Yet, contemporary evidence on the merits of this approach relative to preservation of the uterus through suspension is needed to better inform surgical decision making by patients and their healthcare providers. The objective of this study is to evaluate POP-specific health outcomes and service utilisation of women electing uterine suspension compared with those electing hysterectomy and vaginal vault suspension for POP surgery up to 1-year postsurgery.Methods and analysisThis is a prospective cohort study planning to enrol 321 adult women with stage ≥2 POP from multiple sites in Alberta, Canada. Following standardised counselling from study surgeons, participants self-select either a hysterectomy based or uterine preservation surgical group. Data are being collected through participant questionnaires, medical records and administrative data linkage at four time points spanning from the presurgical consultation to 1-year postsurgery. The primary outcome is anatomic failure to correct POP, and secondary outcomes include changes in positioning of pelvic structures, retreatment, subjective report of bulge symptoms, pelvic floor distress and impact, sexual function and health service use. Data will be analysed using inverse probability weighting of propensity scores and generalised linear models.Ethics and disseminationThis study is approved by the Conjoint Health Research Ethics Board at the University of Calgary (REB19-2134). Results will be disseminated via peer-reviewed publications, presentations at national and international conferences, and educational handouts for patients.Trial registration numberNCT04890951.

scholarly journals Clinical outcome of sacrospinous fixation following pelvic organ prolapse surgery

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Sandesh Poudel ◽  
Ganesh Dangal
Keyword(s):  
Pelvic Organ Prolapse ◽  
Pelvic Organ ◽  
Maternity Hospital ◽  
Prolapse Surgery ◽  
Cross Sectional ◽  
Sacrospinous Fixation ◽  
Midterm Outcome ◽  
Pelvic Organ Prolapse Surgery ◽  
Gluteal Pain

Aims: To evaluate the midterm outcome of sacrospinous fixation done during surgical management of pelvic organ prolapse. Methods: This was an interview based cross sectional follow up study done among the patients who underwent sacrospinous fixation procedure along with pelvic organ prolapse surgery in Kathmandu Model Hospital and Paropakar Maternity Hospital. This was conducted between 15 th February 2021 and 15 th April 2021. Post-operative cases 22 to 30 months (average 2 years) from the day of surgery were included. Results: Out of 321 eligible SSF patients from both the hospital, 156 agreed to participate. Among them, 77 (48%) were in 60-69 years of age and 82% were postmenopausal; 33% were more than para 3; 20% had right gluteal pain that was decreased to 1.9% by 2 years; and 20% had some degree of urgency and stress incontinence. Conclusion: Sacrospinous fixation is safe and effective procedure which can be done during pelvic organ prolapse surgery with good success rate and minimal post-operative complications.

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