Pelvic organ prolapse and uterine preservation: a cohort study (POP-UP study)

Autor: Khaled M K Ismail, Vladimir Kalis, Radovan Pilka, Zdenek Rusavy, Martin Smazinka, Daniel Gagyor
Jazyk: angličtina
Rok vydání: 2021
Předmět:
medicine.medical_treatment
030232 urology & nephrology
Uterus
Cohort Studies
Urogynecology
Gynecologic Surgical Procedures
0302 clinical medicine
LSC
LSH
Cervicopexy
030219 obstetrics & reproductive medicine
Compartment
Incidence (epidemiology)
lcsh:Public aspects of medicine
Obstetrics and Gynecology
General Medicine
LSCH + LSC
Hysteropexy
Treatment Outcome
medicine.anatomical_structure
POP-Q
Female
Research Article
Cohort study
medicine.medical_specialty
Hysterectomy
lcsh:Gynecology and obstetrics
Pelvic Organ Prolapse
03 medical and health sciences
Laparoscopic
medicine
Humans
lcsh:RG1-991
Retrospective Studies
Mesh
Sacrocolpopexy
Hysterectomy procedure
business.industry
lcsh:RA1-1270
Perioperative
Surgery
PFDI
PGI-I
Reproductive Medicine
Concomitant
Laparoscopy
sense organs
TLH + LSC
business
Zdroj: BMC Women's Health, Vol 21, Iss 1, Pp 1-9 (2021)
BMC Women's Health
ISSN: 1472-6874
Popis: Background Abdominal and laparoscopic sacro-colpopexy (LSC) is considered the standard surgical option for the management of a symptomatic apical pelvic organ prolapse (POP). Women who have their uterus, and for whom an LSC is indicated, can have a laparoscopic sacro-hysteropexy (LSH), a laparoscopic supra-cervical hysterectomy and laparoscopic sacro-cervicopexy (LSCH + LSC) or a total laparoscopic hysterectomy and laparoscopic sacro-colpopexy (TLH + LSC). The main aim of this study was to compare clinical and patient reported outcomes of uterine sparing versus concomitant hysterectomy LSC procedures. Methods A retrospective analysis of clinical, imaging and patient reported outcomes at baseline, 3 and 12 months after LSH versus either LSCH + LSC or TLH + LSC between January 2015 and January 2019 in a tertiary referral urogynecology center in Pilsen, the Czech Republic. Results In total, 294 women were included in this analysis (LSH n = 43, LSCH + LSC n = 208 and TLH + LSC n = 43). There were no differences in the incidence of perioperative injuries and complications. There were no statistically significant differences between the concomitant hysterectomy and the uterine sparing groups in any of the operative, clinical or patient reported outcomes except for a significantly lower anterior compartment failure rate (p = 0.017) and higher optimal mesh placement rate at 12 months in women who had concomitant hysterectomy procedures (p = 0.006). Conclusion LSH seems to be associated with higher incidence of anterior compartment failures and suboptimal mesh placement based on postoperative imaging techniques compared to LSC with concomitant hysterectomy.
Databáze: OpenAIRE
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