Transvaginal high uterosacral ligament suspension: An alternative to McCall culdoplasty in the treatment of pelvic organ prolapse

2019 ◽  
Vol 240 ◽  
pp. 278-281 ◽  
Author(s):  
Lorenzo Novara ◽  
Luca Giuseppe Sgro ◽  
Silvia Pecchio ◽  
Laura Ottino ◽  
Veronica Tomatis ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Pelvic Organ ◽  
Uterosacral Ligament ◽  
Uterosacral Ligament Suspension ◽  
Mccall Culdoplasty

scholarly journals To Compare the Effectiveness of Vaginal High Uterosacral Ligament Suspension and McCall's Culdoplasty during Vaginal Hysterectomy for Pelvic Organ Prolapse

2017 ◽  
Vol 5 (2) ◽  
pp. 81-86
Author(s):  
Krutika Bhalerao ◽  
Anuja V Bhalerao ◽  
Richa Garg
Keyword(s):  
Pelvic Organ Prolapse ◽  
Coming Out ◽  
Vaginal Hysterectomy ◽  
Pelvic Organ ◽  
Uterosacral Ligament ◽  
Vaginal Vault ◽  
Care Hospital ◽  
Uterosacral Ligament Suspension ◽  
Vaginal Length ◽  
Vault Suspension

ABSTRACT Introduction Vaginal vault prolapse can be prevented by supporting the vaginal cuff, which is an essential part of hysterectomy, whether done abdominally or vaginally. The American Association of Gynecologic Laparoscopists (AAGL) has recommended for future research, specifically, a randomized trial comparing McCall's culdoplasty (with uterosacral ligament plication) with vaginal high uterosacral ligament suspension (HUSLS) (without plication), since both procedures are accessible to gynecological surgeons without urologic background. Hence, this study was carried out. Aim To compare both anatomic and functional outcomes of patients undergoing vaginal HUSLS or McCall's culdoplasty at the time of vaginal hysterectomy. Materials and methods This hospital-based prospective comparative study was carried out at a tertiary care hospital from January 1, 2013 to December 31, 2015 over a period of 3 years after obtaining Ethical Committee approval. All women attending gynecological outpatient department having symptom of mass coming out of vagina were subjected to detailed history, examination, and later underwent either HUSLS (43) or McCall's culdoplasty (42), for vault suspension with concomitant hysterectomy. The effectiveness of both the procedures was assessed by preoperative and postoperative pelvic organ prolapse quantification (POP-Q) and both were compared. Observations There was statistically significant improvement in all the sites of POP-Q points by HUSLS and McCall's culdoplasty as a method of vault suspension except in total vaginal length (TVL). Vault suspension by HUSLS is better than McCall's culdoplasty. All the points of POP-Q showed better results but the point C was significantly placed at a higher level by HUSLS (p = 0.000) as compared with McCall's culdoplasty. The time required for HUSLS was statistically more as compared with repair by McCall's culdoplasty (81.55/74.53 minutes, T: 1.981, p: 0.05). Complications, such as hemorrhage and ureteric injuries were more in HUSLS (2/43, 4.8%) as compared with McCall's culdoplasty (0/42); this is statistically significant. Conclusion High uterosacral ligament suspension provides excellent suspensory support to vaginal vault. Vagina is suspended over the levator ani with normal axis toward sacrum. By doing HUSLS, the vagina is symmetrically supported directed toward the hollow of sacrum. High uterosacral ligament suspension is highly recommended for young women with POP as vaginal length is not altered at all and so is the quality of life. How to cite this article Bhalerao AV, Bhalerao K, Garg R. To Compare the Effectiveness of Vaginal High Uterosacral Ligament Suspension and McCall's Culdoplasty during Vaginal Hysterectomy for Pelvic Organ Prolapse. J South Asian Feder Menopause Soc 2017;5(2):81-86.

scholarly journals Transvaginal natural orifice transluminal endoscopic surgery for uterosacral ligament suspension: pilot study of 35 cases of severe pelvic organ prolapse

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhiying Lu ◽  
Yisong Chen ◽  
Xiaojuan Wang ◽  
Junwei Li ◽  
Keqin Hua ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Pelvic Organ ◽  
Uterosacral Ligament ◽  
Uterosacral Ligament Suspension ◽  
Efficacy And Safety ◽  
Natural Orifice ◽  
Short Term ◽  
Before And After ◽  
The Mean

Abstract Background To describe the short-term outcomes of transvaginal natural orifice transluminal endoscopic surgery (vNOTES) for uterosacral ligament suspension (USLS) in patients with severe prolapse. Methods This was a retrospective study of patients with severe prolapse (≥ stage 3) who underwent vNOTES for USLS between May 2019 and July 2020. The Pelvic Organ Prolapse Quantification (POP-Q) score, Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire short form (PISQ-12) and Pelvic Floor Inventory-20 (PFDI-20) were used to evaluate physical prolapse and quality of life before and after vNOTES for USLS. Results A total of 35 patients were included. The mean operative duration was 111.7 ± 39.4 min. The mean blood loss was 67.9 ± 35.8 ml. Statistically significant differences were observed between before and after vNOTES USLS in Aa (+ 0.6 ± 1.7 versus − 2.9 ± 0.2), Ba (+ 1.9 ± 2.2 versus − 2.9 ± 0.3), C (+ 1.5 ± 2.2 versus − 6.9 ± 0.9), Ap (− 1.4 ± 1.0 versus − 3.0 ± 0.1) and Bp (− 1.1 ± 1.4 versus − 2.9 ± 0.1) (P < 0.05 for all). The mean pre- and postoperative PFDI-20 score was 19.9 ± 6.7 and 3.2 ± 5.4, respectively, and the mean pre- and postoperative PISQ-12 score was 24.8 ± 2.3 and 38.3 ± 4.1, respectively (P < 0.05 for both). During 1–13 months of follow-up, there were no cases of severe complications or recurrence. Conclusions vNOTES for USLS may be a feasible technique to manage severe prolapse, with promising short-term efficacy and safety. Larger studies with more patients and longer follow-up periods should be performed to evaluate the long-term efficacy and safety profile of vNOTES for USLS.

Uterosacral Ligament Suspension Versus Robotic Sacrocolpopexy for Treatment of Apical Pelvic Organ Prolapse

2019 ◽  
Vol 74 (7) ◽  
pp. 403-404
Author(s):  
Benjamin C. Smith ◽  
Catrina C. Crisp ◽  
Steven D. Kleeman ◽  
Eunsun Yook ◽  
Rachel N. Pauls
Keyword(s):  
Pelvic Organ Prolapse ◽  
Pelvic Organ ◽  
Uterosacral Ligament ◽  
Uterosacral Ligament Suspension ◽  
Robotic Sacrocolpopexy

scholarly journals Laparoscopic uterosacral ligament suspension versus sacrospinous ligament fixation for apical prolapse: perioperative outcomes

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Martina G. Gabra ◽  
Veronica Winget ◽  
Mohammad T. Torabi ◽  
Ilana Addis ◽  
Kenneth Hatch ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Perioperative Complications ◽  
Pelvic Organ ◽  
Uterosacral Ligament ◽  
Perioperative Outcomes ◽  
Complication Rates ◽  
Uterosacral Ligament Suspension ◽  
Confounding Factors ◽  
Sacrospinous Ligament ◽  
Sacrospinous Ligament Fixation

Abstract Background Pelvic organ prolapse can be repaired vaginally or laparoscopically. Studies comparing vaginal repair with sacrospinous ligament fixation (SSLF) or uterosacral ligament suspension (V-USLS) have found no difference in functional or adverse outcomes. Laparoscopic USLS (L-USLS) is becoming a popular treatment for pelvic organ prolapse because it has a low rate of ureteral compromise. To date, no studies have compared perioperative outcomes between L-USLS and SSLF. The objective of this study is to compare the rates of perioperative complications between these two methods. Methods This was a retrospective chart review of 243 consecutive patients who underwent L-USLS or SSLF at one institution between March 2017 and August 2019 for apical pelvic organ prolapse. Descriptive data was analyzed as appropriate with Student’s t tests and chi-square. Univariable logistic regression analysis was performed to assess predictors of perioperative complications. Results Preoperative Pelvic Organ Prolapse Quantification Stage (POP-Q) was similar between the two cohorts (p = 0.23). After adjusting for confounding factors, L-USLS was associated with a longer operative time (118 vs 142 min, p < 0.01) and shorter length of hospitalization (0.68 vs 1.06 days, p < 0.01). The estimated blood loss between the procedures was not statistically significant after adjusting for confounding factors. There was no difference in perioperative complication rates between L-USLS and SSLF (5% vs 7%, p = 0.55). No clinical risk factors were significantly associated with perioperative complications. Conclusion We did not find a difference in complications between L-USLS and SSLF.

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