Literature DB >> 35800747

Mid-term efficacy of surgical treatments for post-hysterectomy vaginal vault prolapse: a retrospective study.

Yinghui Zhang1, Wenying Wang1, Yongxian Lu1, Wenjie Shen1, Ke Niu1.   

Abstract

Background: The surgical treatment of post-hysterectomy vaginal vault prolapse (PHVP) has been reported in several clinical studies, but mostly are short-term studies. This study aims to explore the mid-term efficacy of surgical treatments for PHVP.
Methods: A total of 138 PHVP patients underwent surgery from January 2005 to January 2020 at the Fourth Medical Center of PLA General Hospital, Beijing. The clinical data of 119 patients who completed follow-up were retrospectively analyzed. Both groups of patients are diagnosed Pelvic Organ Prolapse Quantification system (POP-Q) III-IV stage of prolapse, with obvious prolapse-related symptoms and requiring surgical treatment. Among them, pelvic floor reconstruction surgery (RPS) was performed in patients who wanted to retain vaginal function and colpocleisis were used for frail patients who cannot tolerate RPS. We used the POP-Q scores for the objective efficacy evaluation, and use the Pelvic Floor Distress Inventory-Short Form 20 (PFDI-20) and Pelvic Floor Impact Questionnaire-7 (PFIQ-7) to evaluate the subjective symptom during follow up. Among them, 61 patients underwent pelvic floor RPS (Group R), and 58 received colpocleisis (Group C).
Results: The surgeries in both groups were successfully completed, the median follow-up time after surgery was 4.3 years (0.25-13 years) and 5.3 years (0.33-15 years), respectively; the overall surgical success rate was 86.9% (53/61) and 100% (58/58), respectively; the subjective satisfaction rate was 90.2% (55/61) and 91.4% (53/58), respectively; and the PFDI-20 and PFIQ-7 scores in both groups were significantly improved compared with the preoperative levels (P<0.05). In Group R, 6 cases (9.8%, 6/61) were dissatisfied after surgery; in Group C, 5 cases (8.6%, 5/58) were dissatisfied after surgery. Conclusions: Reconstructive surgery and colpocleisis have a good mid-term effect on PHVP, with good outcome and few complications. The surgeon is expected to ascertain an appropriate surgical procedure based on the characteristics of the patient, the degree and the location of prolapse, in order to achieve the best surgical efficacy and minimize the damage. 2022 Gland Surgery. All rights reserved.

Entities:  

Keywords:  Gynecological surgery; post-hysterectomy vaginal vault prolapse (PHVP); treatment outcome

Year:  2022        PMID: 35800747      PMCID: PMC9253193          DOI: 10.21037/gs-22-261

Source DB:  PubMed          Journal:  Gland Surg        ISSN: 2227-684X


  27 in total

1.  Guideline No. 413: Surgical Management of Apical Pelvic Organ Prolapse in Women.

Authors:  Roxana Geoffrion; Maryse Larouche
Journal:  J Obstet Gynaecol Can       Date:  2021-02-03

2.  An estimation of the frequency of surgery for posthysterectomy vault prolapse.

Authors:  Thomas Aigmueller; Andrea Dungl; Susanne Hinterholzer; Ingrid Geiss; Paul Riss
Journal:  Int Urogynecol J       Date:  2010-03       Impact factor: 2.894

3.  [Update of guideline on the diagnosis and treatment of female stress urinary incontinence (2017)].

Authors: 
Journal:  Zhonghua Fu Chan Ke Za Zhi       Date:  2017-05-25

4.  Total colpocleisis for vaginal eversion.

Authors:  J O DeLancey; G W Morley
Journal:  Am J Obstet Gynecol       Date:  1997-06       Impact factor: 8.661

Review 5.  Colpocleisis: a review.

Authors:  Mary P FitzGerald; Holly E Richter; Sohail Siddique; Peter Thompson; Halina Zyczynski
Journal:  Int Urogynecol J Pelvic Floor Dysfunct       Date:  2005-06-28

6.  Subjective and Objective Outcomes of Robotic and Vaginal High Uterosacral Ligament Suspension.

Authors:  Vaneesha Vallabh-Patel; Cristina Saiz; Charbel Salamon
Journal:  Female Pelvic Med Reconstr Surg       Date:  2016 Nov/Dec       Impact factor: 2.091

7.  Enhancing participation of older women in surgical trials.

Authors:  Patricia S Goode; Mary P Fitzgerald; Holly E Richter; William E Whitehead; Ingrid Nygaard; Patricia A Wren; Halina M Zyczynski; Geoffrey Cundiff; Shawn Menefee; Judith M Senka; Xin Gao; Anne M Weber
Journal:  J Am Coll Surg       Date:  2008-05-19       Impact factor: 6.113

8.  Extraperitoneal uterosacral suspension technique for post hysterectomy apical prolapse in 472 women: results from a longitudinal clinical study.

Authors:  D Karmakar; P L Dwyer; E Thomas; L Schierlitz
Journal:  BJOG       Date:  2018-12-27       Impact factor: 6.531

Review 9.  The treatment of post-hysterectomy vaginal vault prolapse: a systematic review and meta-analysis.

Authors:  Anne-Lotte W M Coolen; Bich Ngoc Bui; Viviane Dietz; Rui Wang; Aafke P A van Montfoort; Ben Willem J Mol; Jan-Paul W R Roovers; Marlies Y Bongers
Journal:  Int Urogynecol J       Date:  2017-10-16       Impact factor: 2.894

Review 10.  Surgery for women with apical vaginal prolapse.

Authors:  Christopher Maher; Benjamin Feiner; Kaven Baessler; Corina Christmann-Schmid; Nir Haya; Julie Brown
Journal:  Cochrane Database Syst Rev       Date:  2016-10-01
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