Effects of uterine preservation on long-term subjective outcomes of sacrospinous ligament fixation for the treatment of pelvic organ prolapse
| Autor: | Soo-Cheen Ng, Kwong-Pang Tsui, Gin-Den Chen, Litz Huang |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
medicine.medical_specialty medicine.medical_treatment Uterovaginal prolapse Pelvic Organ Prolapse 03 medical and health sciences Gynecologic Surgical Procedures 0302 clinical medicine Patient satisfaction medicine.ligament Humans Medicine 030212 general & internal medicine Aged Fixation (histology) Pelvic organ Ligaments 030219 obstetrics & reproductive medicine Hysterectomy business.industry Proportional hazards model Uterus Sacrospinous ligament Obstetrics and Gynecology Middle Aged Surgery Treatment Outcome Reproductive Medicine Patient Satisfaction Concomitant Quality of Life Female business Follow-Up Studies |
| Zdroj: | European Journal of Obstetrics & Gynecology and Reproductive Biology. 240:167-171 |
| ISSN: | 0301-2115 |
| DOI: | 10.1016/j.ejogrb.2019.07.006 |
| Popis: | Objective To evaluate the long-term subjective outcomes in women who underwent sacrospinous ligament fixation with and without uterine preservation for treatment of uterovaginal prolapse. Study design Two hundred and ten women with POP-Q≧stage III uterovaginal prolapse, who underwent sacrospinous ligament fixation from January 1994 to December 2007 were included. Patient Global Impression of Improvement was used to assess the surgical outcome in July 2016. Primary outcome measures were subjective success rate and current satisfaction. Kaplan-Meier method and Cox proportional hazard model were used for analysis. Results The mean follow-up was 13.3 years (range 8.5–22.6 years). One hundred and thirty-nine patients were successfully interviewed and analyzed. The cumulative subjective success rate was 88.5% and current satisfaction was 77.7%. The repeat surgery rate was 2.9%. There were no significant differences in subjective success (89% vs. 88%) or current satisfaction (78.1% vs. 77.3%) between uterine preservation (n = 64) and concomitant hysterectomy (n = 75). Kaplan-Meier analysis showed that sacrospinous ligament fixation with uterine preservation had a better subjective outcome at mid-term follow-up but was not significantly different compared with concomitant hysterectomy after long-term follow-up (P = 0.63). The adjusted HR of uterine preservation was 0.75 (95%CI: 0.22–2.12, P = 0.59). Conclusion Sacrospinous ligament fixation with or without uterine preservation in the treatment of women with uterovaginal prolapse has no significant difference in long-term subjective outcomes and patient satisfaction. |
| Databáze: | OpenAIRE |
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