Uterine prolapse | ScienceGate

Background: Pelvic organ prolapse is a common condition, affecting about 50% of women with children. The aim of our study was to evaluate results and complication rates in a consecutive series of female patients undergoing robot-assisted laparoscopic hysterosacropexy (RALHSP). Materials and Methods: We performed a medical record review of female patients with uterine prolapse who had consecutively undergone RALHSP from February 2010 to 2013 at our department. Results: Fifteen patients were included in the analysis. All patients had uterine prolapse stage ≥II and urodynamic stress urinary incontinence. The mean age was 58.26 years. According to the Clavien-Dindo system, 4 out of 15 patients (26.6%) had grade 1 early complications and 1 patient had a grade 2 complication. At a median follow-up of 36 months, there was a significant prolapse relapse rate of 20% (3/15). Conclusion: In our hands RALHSP is easy to perform, with satisfying mid-term outcomes and a low complication rate.

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Cure of Interstitial Cystitis and Non-Ulcerating Hunner’s Ulcer by Cardinal/Uterosacral Ligament Repair

Urologia Internationalis ◽

10.1159/000515647 ◽

2021 ◽

pp. 1-4

Author(s):

Kay Scheffler ◽

Oliver W. Hakenberg ◽

Peter Petros

Keyword(s):

Interstitial Cystitis ◽

Uterine Prolapse ◽

English Literature ◽

German Literature ◽

Uterosacral Ligament ◽

Original Intention ◽

Uterosacral Ligaments ◽

Bladder Symptoms ◽

Posterior Fornix ◽

The Relationship

A serendipitous cure in a 73-year-old woman of Hunner’s ulcer, urge, nocturia, apical prolapse by a tissue fixation system tensioned minisling (TFS) which reinforced the cardinal, and uterosacral ligaments (USLs) led us to analyse the relationship between Hunner’s ulcer and known pain conditions associated with USL laxity. The original intention was to cure the “posterior fornix syndrome” (PFS), uterine prolapse, and associated pain and bladder symptoms by USL repair. A speculum inserted preoperatively into the posterior fornix alleviated pain and urge symptoms, by mechanically supporting USLs. Hunner’s ulcer, along with pain and other PFS symptoms were cured by USL repair. The concept of USL laxity causing chronic pelvic pain and bladder problems is not new. It was published in the German literature by Heinrich Martius in 1938 and by Petros in the English literature in 1993. These findings raise important questions. As PFS symptoms are identical with those of interstitial cystitis (IC), are PFS and IC similar conditions? If so, then patients with IC who have a positive speculum test are at least theoretically, potentially curable by USL repair. These questions need to be explored.

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Comparison of treatment outcomes for native tissue repair and sacrocolpopexy as apical suspension procedures at the time of hysterectomy for uterine prolapse

Scientific Reports ◽

10.1038/s41598-021-82732-0 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Sumin Oh ◽

E. Kyung Shin ◽

Sowoon Hyun ◽

Myung Jae Jeon

Keyword(s):

Treatment Outcomes ◽

Tissue Repair ◽

Uterine Prolapse ◽

Reoperation Rate ◽

Complication Rates ◽

Native Tissue Repair ◽

Apical Suspension ◽

Native Tissue ◽

Surgical Failure

AbstractConcomitant apical suspension should be performed at the time of hysterectomy for uterine prolapse to reduce the risk of recurrent prolapse. Native tissue repair (NTR) and sacrocolpopexy (SCP) are commonly used apical suspension procedures; however, it remains unclear which one is preferred. This study aimed to compare the treatment outcomes of NTR and SCP in terms of surgical failure, complication and reoperation rates. Surgical failure was defined as the presence of vaginal bulge symptoms, any prolapse beyond the hymen, or retreatment for prolapse. This retrospective cohort study included 523 patients who had undergone NTR (n = 272) or SCP (n = 251) along with hysterectomy for uterine prolapse and who had at least 4-month follow-up visits. During the median 3-year follow-up period, the surgical failure rate was higher in the NTR group (21.3% vs 6.4%, P < 0.01), with a low rate of retreatment in both groups. Overall complication rates were similar, but complications requiring surgical correction under anesthesia were more common in the SCP group (7.2% vs 0.4%, P < 0.01). As a result, the total reoperation rate was significantly higher in the SCP group (8.0% vs 2.6%, P = 0.02). Taken together, NTR may be a preferred option for apical suspension when hysterectomy is performed for uterine prolapse.

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OPERATION FOR UTERINE PROLAPSE

The Medical Journal of Australia ◽

10.5694/j.1326-5377.1924.tb65320.x ◽

1924 ◽

Vol 1 (2) ◽

pp. 37-39

Author(s):

F. A. Gill

Keyword(s):

Uterine Prolapse

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The effectiveness of McCall culdoplasty following vaginal hysterectomy in advanced stages of uterine prolapse

International Urogynecology Journal ◽

10.1007/s00192-021-04890-z ◽

2021 ◽

Author(s):

Elad Barber ◽

Ilia Kleiner ◽

Daniel Tairy ◽

Jacob Bar ◽

Shimon Ginath

Keyword(s):

Vaginal Hysterectomy ◽

Uterine Prolapse ◽

Mccall Culdoplasty ◽

Advanced Stages

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Laparoscopic sacrohysteropexy versus vaginal hysterectomy and apical suspension: 7-year follow-up of a randomized controlled trial

International Urogynecology Journal ◽

10.1007/s00192-021-04932-6 ◽

2021 ◽

Author(s):

Matthew L. Izett-Kay ◽

Philip Rahmanou ◽

Rufus J. Cartwright ◽

Natalia Price ◽

Simon R. Jackson

Keyword(s):

Vaginal Hysterectomy ◽

Uterine Prolapse ◽

Controlled Trial ◽

Apical Prolapse ◽

Apical Suspension ◽

Vaginal Length ◽

Patient Reported ◽

Laparoscopic Sacrohysteropexy ◽

Total Vaginal Length

Abstract Introduction and hypothesis Laparoscopic mesh sacrohysteropexy offers a uterine-sparing alternative to vaginal hysterectomy with apical suspension, although randomised comparative data are lacking. This study was aimed at comparing the long-term efficacy of laparoscopic mesh sacrohysteropexy and vaginal hysterectomy with apical suspension for the treatment of uterine prolapse. Methods A randomised controlled trial comparing laparoscopic mesh sacrohysteropexy and vaginal hysterectomy with apical suspension for the treatment of uterine prolapse was performed, with a minimum follow-up of 7 years. The primary outcome was reoperation for apical prolapse. Secondary outcomes included patient-reported mesh complications, Pelvic Organ Prolapse Quantification, Patient Global Impression of Improvement in prolapse symptoms and the International Consultation on Incontinence Questionnaire Vaginal Symptoms, Female Lower Urinary Tract Symptoms (ICIQ-FLUTS) and PISQ-12 questionnaires. Results A total of 101 women were randomised and 62 women attended for follow-up at a mean of 100 months postoperatively (range 84–119 months). None reported a mesh-associated complication. The risk of reoperation for apical prolapse was 17.2% following vaginal hysterectomy (VH) and 6.1% following laparoscopic mesh sacrohysteropexy (LSH; relative risk 0.34, 95% CI 0.07–1.68, p = 0.17). Laparoscopic sacrohysteropexy was associated with a statistically significantly higher apical suspension (POP-Q point C −5 vs −4.25, p = 0.02) and longer total vaginal length (9 cm vs 6 cm, p < 0.001). There was no difference in the change in ICIQ-VS scores between the two groups (ICIQ-VS change −22 vs −25, p = 0.59). Conclusion Laparoscopic sacrohysteropexy and vaginal hysterectomy with apical suspension have comparable reoperation rates and subjective outcomes. Potential advantages of laparoscopic sacrohysteropexy include a lower risk of apical reoperation, greater apical support and increased total vaginal length.

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