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Multicenter Study
. 2022 Oct 1;28(10):687-694.
doi: 10.1097/SPV.0000000000001226. Epub 2022 Jul 9.

Comparing Minimally Invasive Sacrocolpopexy With Vaginal Uterosacral Ligament Suspension: A Multicenter Retrospective Cohort Study Through the Fellows' Pelvic Research Network

Nabila Noor, Dina Bastawros  1 , Marian E Florian-Rodriguez  2 , Deslyn Hobson  3 , Chidimma Eto  4 , Svjetlana Lozo  5 , Erin Lavelle  6 , Danielle Antosh  7 , Michele R Hacker, Eman Elkadry, Emily Von Bargen
Affiliations
Multicenter Study

Comparing Minimally Invasive Sacrocolpopexy With Vaginal Uterosacral Ligament Suspension: A Multicenter Retrospective Cohort Study Through the Fellows' Pelvic Research Network

Nabila Noor et al. Urogynecology (Phila). .

Abstract

Importance: Comparing one-year surgical outcomes of two widely used surgical procedures for apical suspension.

Objectives: The objective of this study is to compare anatomic outcomes after minimally invasive sacrocolpopexy (MISC) and vaginal uterosacral ligament suspension (vUSLS).

Study design: This was a multicenter, retrospective cohort study through the Fellows' Pelvic Research Network. Patients with ≥ stage II pelvic organ prolapse (POP) who underwent MISC or vUSLS from January 2013 to January 2016, identified through the Current Procedural Terminology codes, with 1 year or longer postoperative data were included. Patients with prior POP surgery or history of connective tissue disorders were excluded. Anatomic success was defined as Pelvic Organ Prolapse Quantification System measurements: Ba/Bp ≤ 0 or C ≤ -TVL/2. Data were compared using χ 2 or Fisher exact tests. Continuous data were compared using Wilcoxon rank sum test.

Results: Three hundred thirty-seven patients underwent MISC (171 laparoscopic, 166 robotic) and 165 underwent vUSLS. The MISC group had longer operative time (205.9 minutes vs 187.5 minutes, P = 0.006) and lower blood loss (77.8 mL vs 187.4 mL; P < 0.001). Two patients (0.6%) in the MISC group had mesh exposure requiring surgical excision. Permanent suture exposure was higher after vUSLS (6.1%). At 1 year, anatomic success was comparable in the apical (322 [97%] MISC vs 160 [97%] vUSLS, P = 0.99) and posterior compartments (326 [97.6%] MISC vs 164 [99.4%] vUSLS; P = 0.28). Anterior compartment success was higher in the MISC group (328 [97.9%] vs 156 [94.9%], P = 0.04) along with longer total vaginal length (9.2 ± 1.8 vs 8.4 ± 1.5, P < 0.001).

Conclusion: At 1 year, patients who underwent MISC or vUSLS had similar apical support. Low rates of mesh and suture exposures, less anterior recurrence, and longer TVL were noted after MISC.

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Conflict of interest statement

The authors have declared they have no conflicts of interest.

Figures

Figure 1.
Figure 1.
Patient recruitment schematic
Figure 1.
Figure 1.
Patient recruitment schematic
See this image and copyright information in PMC

References

    1. Wu JM, et al., Lifetime risk of stress urinary incontinence or pelvic organ prolapse surgery. Obstet Gynecol, 2014. 123(6): p. 1201–1206. - PMC - PubMed
    1. Rooney K, et al., Advanced anterior vaginal wall prolapse is highly correlated with apical prolapse. Am J Obstet Gynecol, 2006. 195(6): p. 1837–40. - PubMed
    1. Haylen BT, et al., An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J, 2010. 21(1): p. 5–26. - PubMed
    1. Jelovsek JE, et al., Effect of Uterosacral Ligament Suspension vs Sacrospinous Ligament Fixation With or Without Perioperative Behavioral Therapy for Pelvic Organ Vaginal Prolapse on Surgical Outcomes and Prolapse Symptoms at 5 Years in the OPTIMAL Randomized Clinical Trial. Jama, 2018. 319(15): p. 1554–1565. - PMC - PubMed
    1. Lavelle ES, et al., Prolapse recurrence following sacrocolpopexy vs uterosacral ligament suspension: a comparison stratified by Pelvic Organ Prolapse Quantification stage. American Journal of Obstetrics and Gynecology, 2018. 218(1): p. 116.e1–116.e5. - PMC - PubMed

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