Back to the future: vaginal hysterectomy and Campbell uterosacral ligaments suspension for urogenital prolapse
| Autor: | Caroline Pettenati, F. Cour, A. Vidart, Pierre-Olivier Bosset, Thierry Lebret, Titouan Kennel |
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| Přispěvatelé: | Université de Versailles Saint-Quentin-en-Yvelines - UFR Sciences de la santé Simone Veil (UVSQ Santé), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Hôpital Foch [Suresnes], Authors wish to acknowledge Elodie Menechal, secretary for functional urology, who significantly contributed to the study with technical assistance and data collection. |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Urology medicine.medical_treatment Uterosacral ligament 030232 urology & nephrology Urinary incontinence [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics Hysterectomy Asymptomatic Pelvic Organ Prolapse 03 medical and health sciences 0302 clinical medicine Lower urinary tract symptoms Non-mesh Hysterectomy Vaginal medicine Vaginal native tissue repair Humans Urogenital prolapse Retrospective Studies 2. Zero hunger Ligaments 030219 obstetrics & reproductive medicine Genitourinary system business.industry Obstetrics and Gynecology Uterine prolapse medicine.disease Uterosacral ligaments 3. Good health Surgery Treatment Outcome medicine.anatomical_structure Concomitant Female medicine.symptom business Cystocele |
| Zdroj: | International Urogynecology Journal International Urogynecology Journal, Springer Verlag, 2021, 32 (6), pp.1579-1587. ⟨10.1007/s00192-021-04674-5⟩ |
| ISSN: | 0937-3462 1433-3023 |
| DOI: | 10.1007/s00192-021-04674-5⟩ |
| Popis: | International audience; Introduction and hypothesis: To evaluate vaginal hysterectomy (VH) associated with vaginal native tissue repair (VNTR) using Campbell uterosacral ligament suspension (C-USLS) for the treatment of predominant uterine prolapse associated with cystocele. Methods: We conducted a retrospective monocentric study including patients who underwent VH and C-USLS, without concomitant mesh, for primary urogenital prolapse between January 2011 and June 2018. We evaluated the anterior and apical prolapse recurrence rate, using a composite criterion (symptomatic, asymptomatic recurrence, POP-Q stage ≥ 2). We analyzed 2-year recurrence-free survival using the Kaplan-Meier method. Univariate and multivariate analyses were performed to identify variables associated with recurrence. Secondary outcomes included postoperative complications, lower urinary tract symptoms (LUTS) and sexual satisfaction. Results: Ninety-four patients were included. Eighty-three (88.3%) and 65 (69.1%) patients had stage ≥ 3 uterine prolapse and cystocele, respectively. Mean follow-up was 36 months. Prolapse recurrence rate was 21.3% including 3.2% of cystocele. Two-year recurrence-free survival was 80%. Age, body mass index, POP-Q stage and associated surgical procedure were not significantly associated with recurrence. Early complications were reported for 20 patients (21.2%), mostly grade ≤ 2 (95%). De novo LUTS were reported in 11 cases (11.7%). Preoperative stress urinary incontinence and urgency were cured for 12 (80%) and 29 (80.6%) patients, respectively. Sexual satisfaction rate for patients with preoperative sexual activity was 95.8%. Conclusion: C-USLS following VH as primary treatment for predominant uterine prolapse with associated cystocele is a safe procedure with satisfying mid-term functional results. This VNTR could be an alternative in light of the worldwide market withdrawal of actual vaginal mesh. |
| Databáze: | OpenAIRE |
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