Highlights
- •Equally satisfactory objective and subjective long-term outcomes are achieved after laparoscopic uterosacral suspension with or without hysterectomy.
- •Postoperative complication rates were low in both groups.
- •Laparoscopic uterosacral hysteropexy is safe and effective.
Abstract
Objectives
This study compares the recurrence rate, complication rate and subjective satisfaction
with laparoscopic uterosacral suspension with or without hysterectomy.
Study design
This retrospective cohort study included 105 patients between June 2014 and December
2019. Recurrent pelvic organ prolapse was defined as any prolapse to or beyond the
hymen with straining or needing retreatment. Student's t-test, the Mann–Whitney U test, the chi square test or Fisher's exact test, multivariate Cox proportional hazards
regression and Kaplan–Meier survival analysis were used for the data analysis.
Main outcome measures
Whether the durability of laparoscopic uterosacral suspension surgery is affected
by uterine preservation.
Results
60 patients underwent laparoscopic uterosacral suspension with concomitant hysterectomy
(Hysterectomy group), and 45 underwent laparoscopic uterosacral hysteropexy (Hysteropexy
group). The median (interquartile range) duration of follow-up for all 105 patients
was 31 (22.5–47.5) months. The results of multivariate Cox proportional hazards regression
showed that no difference was found in the risk of overall recurrence between the
hysterectomy and hysteropexy groups (25 % vs. 22 %; HR, 0.37; 95 % CI, 0.14–1.00).
Kaplan–Meier survival analysis also demonstrated that there were no significant differences
in the overall rates of recurrent prolapse between the two groups (P = 0.30). In addition, the subjective success rates were high in both groups (82 %).
Conclusions
Our study demonstrated equally satisfactory objective and subjective long-term outcomes
after laparoscopic uterosacral suspension with or without hysterectomy. Laparoscopic
uterosacral hysteropexy can be safely and effectively offered to patients with pelvic
organ prolapse who wish to preserve their uterus and do not have contraindications.
Keywords
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Article info
Publication history
Accepted:
January 6,
2023
Received in revised form:
November 14,
2022
Received:
August 29,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Published by Elsevier B.V.
