Laparoscopic sacrohysteropexy versus vaginal hysterectomy for uterovaginal prolapse using validated questionnaires: 2-year prospective study

被引:12
|
作者
Lone, Farah [1 ]
Curnow, Tamara [2 ]
Thomas, Sarah Anne [1 ]
机构
[1] Royal Cornwall Hosp, Dept Obstet & Gynecol, Truro, England
[2] Bodriggy Hlth Ctr, Hayle, Cornwall, England
关键词
ICIQ-vs; ICIQ-UI; Pop-q; Uterovaginal prolapse; Vaginal hysterectomy; Laparoscopic sacrohysteropexy; PELVIC ORGAN PROLAPSE; FUNCTIONAL OUTCOMES; SURGICAL-CORRECTION; VAULT PROLAPSE; FOLLOW-UP; HYSTEROPEXY; SURGERY; ICIQ; PRESERVATION; MANAGEMENT;
D O I
10.1007/s00192-017-3405-5
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Surgical options for uterovaginal prolapse can be categorized into uterus conservation-e.g., laparoscopic sacrohysteropexy (LSHP) or vaginal hysterectomy (VH). There is insufficient reliable information on long-term comparative outcomes of these procedures. The primary aim of this study was to compare subjective and objective outcomes of LSHP and VH. The secondary aim was to record adverse events, recurrent prolapse, and new-onset stress urinary incontinence (SUI) up to 2 years. Women with symptomatic uterovaginal prolapse who opted for either LSHP or VH were included. Subjective outcomes were compared at 1 and 2 years from baseline using the validated questionnaires. Objective/anatomical outcomes using the Pelvic Organ Prolapse Quantification (POP-Q) system were assessed before and at 3 months after surgery. Adverse events, recurrent prolapse, and new-onset SUI was recorded up to 2 years. The study assessed 226 women with uterovaginal prolapse; 125 opted for surgery (44 LSHP, 81 VH). There was no statistically significant difference in symptom domains between groups at baseline and 1 and 2 years. At 3 months POP-Q, greater improvement was seen in points Ba and Ap in the LSHP group compared to VH group and smaller genital hiatus was seen in the VH group. Adverse events, recurrent prolapse, or new-onset SUI were not significantly different in the two groups. Both LSHP and VH are effective surgical options for uterovaginal prolapse. At 2 years, both procedures had similar improvement in symptom domains, overall scores, adverse events, recurrent prolapse, and new-onset SUI. Long-term randomized studies are needed.
引用
收藏
页码:71 / 79
页数:9
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