AI Article Synopsis

  • - The study evaluated the effectiveness and complications of high uterosacral ligament (USL) suspension as a surgery for managing pelvic organ prolapse (POP) in a large group of patients over a 12-year period.
  • - Out of 1,099 patients, the surgery had a low complication rate of 3.4% and a recurrence rate of 12.4%, with only 0.9% requiring reoperation due to prolapse recurrence.
  • - Postoperative results showed significant improvements in various pelvic dysfunctions, indicating that high USL suspension is a safe and effective primary treatment for POP.

Article Abstract

Introduction And Hypothesis: Surgical repair is the mainstay of genital prolapse management. Among native-tissue apical procedures, high uterosacral ligaments suspension is considered a valid and effective option for central compartment repair. In this study, we aimed to evaluate the effectiveness, complications rate, and functional results of high USL suspension as a primary prolapse repair technique in a large cohort of patients.

Methods: Patients who underwent vaginal hysterectomy followed by high uterosacral ligaments suspension for POP between January 2008 and December 2020 were retrospectively analyzed. Questionnaires and clinical interviews were preoperatively performed to assess symptoms and severity of urinary, bowel, and sexual dysfunctions. After surgical procedure, diagnostic cystoscopy was performed to evaluate ureteral patency. Postoperative data, objective, and subjective cure rate were then noted at the follow-up evaluation.

Results: A total of 1099 patients underwent high uterosacral ligaments suspension. The total complication rate was 3.4 % and recurrence in any of the vaginal compartments was 12.4 %. Reoperation for symptomatic prolapse recurrence or pessary treatment was required in 9 women (0.9 %). In the evaluation of postoperative questionnaires, functional outcomes analysis revealed a significant improvement (p < 0.05) in terms of stress urinary incontinence, urge urinary incontinence, voiding symptoms, constipation, and dyspareunia after prolapse repair.

Conclusion: Uterosacral ligament suspension is a safe and effective procedure for primary surgical treatment of pelvic organ prolapse. Anatomical, functional, and subjective outcomes were very satisfactory, and the reoperation rate for recurrence was below 1%.

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Source
http://dx.doi.org/10.1016/j.ejogrb.2024.08.020DOI Listing

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