Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jun;32(6):1555-1563.
doi: 10.1007/s00192-020-04641-6. Epub 2021 Jan 13.

Short-term outcomes of sacrospinous hysteropexy through an anterior approach

Andre Plair  1 , Rahul Dutta  1 , Tyler L Overholt  1 , Catherine Matthews  2
Affiliations

Short-term outcomes of sacrospinous hysteropexy through an anterior approach

Andre Plair et al. Int Urogynecol J. 2021 Jun.

Abstract

Introduction and hypothesis: The posterior approach to sacrospinous hysteropexy has been well studied but little is known about the anterior approach. This study assessed the efficacy and complications of an anterior approach to sacrospinous hysteropexy compared to hysterectomy with apical repair. We hypothesized that anterior sacrospinous hysteropexy has similar efficacy and fewer complications.

Methods: This retrospective cohort study compared patients who underwent native-tissue anterior sacrospinous hysteropexy (cases) with those who underwent hysterectomy with apical repair (controls). Composite success was defined as (1) leading edge of prolapse not beyond the hymen and apex not descended > 1/3 total vaginal length; (2) no vaginal bulge symptoms; (3) no prolapse retreatment. Descriptive and bivariate statistics were performed as well as a Cox regression analysis for time to failure.

Results: Fifty cases and 97 controls were compared. The median follow-up time was 7.6 months. Operative time was shorter in the hysteropexy group (110.7 vs. 155.9 min, p < 0.001). The composite success was 92% for both cases and controls (p = 1.000) with no difference in time to surgical failure (p = 0.183). There were no serious intraoperative complications in the hysteropexy group and six in the control group (3 transfusions, 1 conversion to laparotomy, 1 ureteral injury, 1 cystotomy; p = 0.101). There was no difference in the number of postoperative complications (22.0% vs. 30.9%, p = 0.203).

Conclusions: For primary uterine prolapse, anterior sacrospinous hysteropexy has similar short-term efficacy compared to hysterectomy with apical repair with shorter operative time and a trend towards fewer serious complications.

Keywords: Native tissue repair; Pelvic organ prolapse; Sacrospinous hysteropexy; Uterine preservation surgery; Uterine prolapse.

PubMed Disclaimer

References

    1. Gutman RE. Does the uterus need to be removed to correct uterovaginal prolapse? Curr Opin Obstet Gynecol. 2016;28(5):435–40. - DOI
    1. Kapoor S, et al. Sacrospinous hysteropexy: review and meta-analysis of outcomes. Int Urogynecol J. 2017;28(9):1285–94. - DOI
    1. Bradley S, Gutman RE, Richter LA. Hysteropexy: an option for the repair of pelvic organ prolapse. Curr Urol Rep. 2018;19(2):15. - DOI
    1. Maher CF, et al. Uterine preservation or hysterectomy at sacrospinous colpopexy for uterovaginal prolapse? Int Urogynecol J Pelvic Floor Dysfunct. 2001;12(6):381–4 discussion 384-5. - DOI
    1. Hefni M, et al. Sacrospinous cervicocolpopexy with uterine conservation for uterovaginal prolapse in elderly women: an evolving concept. Am J Obstet Gynecol. 2003;188(3):645–50. - DOI

LinkOut - more resources