Shveta Kapoor1, Kanapathippillai Sivanesan2, Jessica Amy Robertson1, Mayooran Veerasingham1, Vishal Kapoor3. 1. Ipswich Hospital, QLD Health, University of Queensland, Chelmsford Avenue, Ipswich, QLD, 4305, Australia. 2. Ipswich Hospital, QLD Health, University of Queensland, Chelmsford Avenue, Ipswich, QLD, 4305, Australia. sivanezan@gmail.com. 3. Lady Cilento Children's Hospital, QLD Health, University of Queensland, South Brisbane, QLD, Australia.
Abstract
INTRODUCTION: Sacrospinous hysteropexy is a uterine-preserving procedure for treatment of apical prolapse. We present a literature review evaluating the sacrospinous hysteropexy procedure and its current place in the surgical management of pelvic organ prolapse. Additionally, to assess the efficacy of the procedure, we performed a meta-analysis of studies comparing sacrospinous hysteropexy to vaginal hysterectomy and repair in terms of anatomical outcomes, complications, and repeat surgery. METHODS: Major literature databases including MEDLINE (1946 to 2 April 2016), Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 3), and Embase (1947 to 2 April 2016) were searched for relevant studies. We used Cochrane Collaboration's Review Manager software to perform meta-analysis of randomized controlled studies and observational studies. RESULTS: Vaginal sacrospinous hysteropexy was first performed in 1989 and is similar in technique to sacrospinous colpopexy. Two randomized controlled trials and four cohort studies (n = 651) were included in the meta-analysis. Apical failure rates after sacrospinous hysteropexy versus vaginal hysterectomy were not significantly different, although the trend favored vaginal hysterectomy [odds ratio (OR) 2.08; 95% confidence interval (CI) 0.76-5.68]. Rates of repeat surgery for prolapse were not significantly different between the two groups (OR 0.99; 95% CI 0.41-2.37). The most significant disadvantage of uterine-preservation prolapse surgery when compared with hysterectomy is the lack of prevention and diagnosis of uterine malignancy. CONCLUSION: Sacrospinous hysteropexy is a safe and effective procedure for pelvic organ prolapse and has comparable outcomes to vaginal hysterectomy with repair.
INTRODUCTION: Sacrospinous hysteropexy is a uterine-preserving procedure for treatment of apical prolapse. We present a literature review evaluating the sacrospinous hysteropexy procedure and its current place in the surgical management of pelvic organ prolapse. Additionally, to assess the efficacy of the procedure, we performed a meta-analysis of studies comparing sacrospinous hysteropexy to vaginal hysterectomy and repair in terms of anatomical outcomes, complications, and repeat surgery. METHODS: Major literature databases including MEDLINE (1946 to 2 April 2016), Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 3), and Embase (1947 to 2 April 2016) were searched for relevant studies. We used Cochrane Collaboration's Review Manager software to perform meta-analysis of randomized controlled studies and observational studies. RESULTS: Vaginal sacrospinous hysteropexy was first performed in 1989 and is similar in technique to sacrospinous colpopexy. Two randomized controlled trials and four cohort studies (n = 651) were included in the meta-analysis. Apical failure rates after sacrospinous hysteropexy versus vaginal hysterectomy were not significantly different, although the trend favored vaginal hysterectomy [odds ratio (OR) 2.08; 95% confidence interval (CI) 0.76-5.68]. Rates of repeat surgery for prolapse were not significantly different between the two groups (OR 0.99; 95% CI 0.41-2.37). The most significant disadvantage of uterine-preservation prolapse surgery when compared with hysterectomy is the lack of prevention and diagnosis of uterine malignancy. CONCLUSION: Sacrospinous hysteropexy is a safe and effective procedure for pelvic organ prolapse and has comparable outcomes to vaginal hysterectomy with repair.
Authors: Charles W Nager; Anthony G Visco; Holly E Richter; Charles R Rardin; Rebecca G Rogers; Heidi S Harvie; Halina M Zyczynski; Marie Fidela R Paraiso; Donna Mazloomdoost; Scott Grey; Amaanti Sridhar; Dennis Wallace Journal: JAMA Date: 2019-09-17 Impact factor: 56.272
Authors: Sascha F M Schulten; Rosa A Enklaar; Kirsten B Kluivers; Sanne A L van Leijsen; Marijke C Jansen-van der Weide; Eddy M M Adang; Jeroen van Bavel; Heleen van Dongen; Maaike B E Gerritse; Iris van Gestel; G G Alec Malmberg; Ronald J C Mouw; Deliana A van Rumpt-van de Geest; Wilbert A Spaans; Annemarie van der Steen; Jelle Stekelenburg; E Stella M Tiersma; Anneke C Verkleij-Hagoort; Astrid Vollebregt; Chantal B M Wingen; Mirjam Weemhoff; Hugo W F van Eijndhoven Journal: BMC Womens Health Date: 2019-04-02 Impact factor: 2.809
Authors: Sascha F M Schulten; Renée J Detollenaere; Jelle Stekelenburg; Joanna IntHout; Kirsten B Kluivers; Hugo W F van Eijndhoven Journal: BMJ Date: 2019-09-10