Retrospective analysis of apical prolapse correction by unilateral pectineal suspension: perioperative and short-term results

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Introduction and hypothesis

We have previously published the novel method of unilateral pectineal suspension (UPS) for apical prolapse correction. UPS provides mesh-free midline uterus suspension using a single non-absorbable suture to attach the anterior cervix to the lateral part of the iliopectineal ligament. The purpose of this retrospective cohort study was to analyze the short-term efficacy, perioperative complication rate, and overall patient acceptance of the new UPS surgical concept.

Methods

Forty-seven patients with POP-Q stage 2–4 who underwent robotic UPS between January 1, 2020 and December 31, 2021 were included in the study. Patient data were taken retrospectively from the patient files. Treatment success was the primary endpoint, measured both objectively using a defined composite endpoint and subjectively according to patients’ acceptance 3–6 months after surgery during a follow-up examination. Secondary outcome measures included complications and conversions, and effect of additional procedures on operative time.

Results

Treatment success as measured by the defined composite endpoint was 93.6% for the entire cohort. No complications or conversions occurred. Mean operation time for isolated UPS was 46.5 min ( n = 33 patients). UPS can be easily combined with additional surgical procedures for repair of remaining pelvic floor defects, incontinence surgery or other indications. Additional procedures performed had a significant influence on operation time ( p < 0.0005, n = 14).

Conclusions

UPS shows highly favorable results when looking at an unselected cohort of patients in need of primary POP surgery with respect to established quality parameters of POP repair.

Related collections

Most cited references 24

Record: found
Abstract: found
Article: not found

Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence.

Lincoln Colling, Jeppe A. Olsen, Robin Smith … (1997)

To determine the incidence of surgically managed pelvic organ prolapse and urinary incontinence in a population-based cohort, and to describe their clinical characteristics. Our retrospective cohort study included all patients undergoing surgical treatment for prolapse and incontinence during 1995; all were members of Kaiser Permanente Northwest, which included 149,554 women age 20 or older. A standardized data-collection form was used to review all inpatient and outpatient charts of the 395 women identified. Variables examined included age, ethnicity, height, weight, vaginal parity, smoking history, medical history, and surgical history, including the preoperative evaluation, procedure performed, and details of all prior procedures. Analysis included calculation of age-specific and cumulative incidences and determination of the number of primary operations compared with repeat operations performed for prolapse or incontinence. The age-specific incidence increased with advancing age. The lifetime risk of undergoing a single operation for prolapse or incontinence by age 80 was 11.1%. Most patients were older, postmenopausal, parous, and overweight. Nearly half were current or former smokers and one-fifth had chronic lung disease. Reoperation was common (29.2% of cases), and the time intervals between repeat procedures decreased with each successive repair. Pelvic floor dysfunction is a major health issue for older women, as shown by the 11.1% lifetime risk of undergoing a single operation for pelvic organ prolapse and urinary incontinence, as well as the large proportion of reoperations. Our results warrant further epidemiologic research in order to determine the etiology, natural history, and long-term treatment outcomes of these conditions.

0 comments Cited 152 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Epidemiology and outcome assessment of pelvic organ prolapse.

Christopher Maher, Linda Barber (2013)

The aim was to determine the incidence and prevalence of pelvic organ prolapse surgery and describe how outcomes are reported. Every 4 years and as part of the Fifth International Collaboration on Incontinence we reviewed the English-language scientific literature after searching PubMed, Medline, Cochrane library and Cochrane database of systematic reviews, published up to January 2012. Publications were classified as level 1 evidence (randomised controlled trials [RCT] or systematic reviews, level 2 (poor quality RCT, prospective cohort studies), level 3 (case series or retrospective studies) and level 4 (case reports). The highest level of evidence was utilised by the committee to make evidence-based recommendations based upon the Oxford grading system. A grade A recommendation usually depends on consistent level 1 evidence. A grade B recommendation usually depends on consistent level 2 and/or 3 studies, or "majority evidence" from RCTs. A grade C recommendation usually depends on level 4 studies or "majority evidence" from level 2/3 studies or Delphi processed expert opinion. A grade D "no recommendation possible" would be used where the evidence is inadequate or conflicting and when expert opinion is delivered without a formal analytical process, such as by Delphi . Pelvic organ prolapse (POP) when defined by symptoms has a prevalence of 3-6% and up to 50% when based upon vaginal examination. Surgery for prolapse is performed twice as commonly as continence surgery and prevalence varies widely from 6 to 18%. The incidence of POP surgery ranges from 1.5 to 1.8 per 1,000 women years and peaks in women aged 60-69. When reporting outcomes of the surgical management of prolapse, authors should include a variety of standardised anatomical and functional outcomes. Anatomical outcomes reported should include all POP-Q points and staging, utilising a traditional definition of success with the hymen as the threshold for success. Assessment should be prospective and assessors blinded as to the surgical intervention performed if possible and without any conflict of interest related to the assessment undertaken (grade C). Subjective success postoperatively should be defined as the absence of a vaginal bulge (grade C). Functional outcomes are best reported using valid, reliable and responsive symptom questionnaires and condition-specific HRQOL instruments (grade C). Sexual function is best reported utilising validated condition-specific HRQOL that assess sexual function or validated sexual function questionnaires such as the Pelvic Organ Prolapse/Incontinence Sexual Questionnaire (PISQ) or the Female Sexual Function Index (FSFI). The sexual activity status of all study participants should be reported pre- and postoperatively under the following categories: sexually active without pain, sexually active with pain or not sexually active (grade C). Prolapse surgery should be defined as primary surgery, and repeat surgery sub-classified as primary surgery different site, repeat surgery, complications related to surgery and surgery for non-prolapse-related conditions (grade C). Significant variation exists in the prevalence and incidence of pelvic organ prolapse surgery and how the outcomes are reported. Much of the variation may be improved by standardisation of definitions and outcomes of reporting on pelvic organ prolapse surgery.

0 comments Cited 147 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

An International Urogynecological Association (IUGA) / International Continence Society (ICS) joint report on the terminology for female pelvic organ prolapse (POP).

Bernard Haylen, Christopher Maher, Matthew Barber … (2016)

The terminology for female pelvic floor prolapse (POP) should be defined and organized in a clinically-based consensus Report.

0 comments Cited 60 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Dimitrios Ilias Bolovis:

ORCID: http://orcid.org/0000-0002-4935-2328

dimitrios.bolovis@klinikum-nuernberg.de

Journal

Journal ID (nlm-ta): Int Urogynecol J

Journal ID (iso-abbrev): Int Urogynecol J

Title: International Urogynecology Journal

Publisher: Springer International Publishing (Cham )

ISSN (Print): 0937-3462

ISSN (Electronic): 1433-3023

Publication date (Electronic): 14 February 2023

Publication date PMC-release: 14 February 2023

Publication date (Print): 2023

Volume: 34

Issue: 8

Pages: 1877-1884

Affiliations

[1 ]GRID grid.511981.5, University Women’s Hospital, Paracelsus Medical University, ; Nuremberg, Germany

[2 ]Georg Simon Ohm Technical University, Nuremberg, Germany

[3 ]GRID grid.21604.31, ISNI 0000 0004 0523 5263, Research Program Experimental Ophthalmology and Glaucoma Research, Paracelsus Medical University, ; Salzburg, Austria

[4 ]GRID grid.21604.31, ISNI 0000 0004 0523 5263, Department of Research and Innovation, , Paracelsus Medical University, ; Salzburg, Austria

[5 ]Department of Obstetrics and Gynecology, Klinikum Nuremberg, Prof.-Ernst-Nathan-Str. 1, 90419 Nuremberg, Germany

[6 ]Barmherzige Brüder Krankenhaus, St. Veit/Glan, Austria

[7 ]GRID grid.21604.31, ISNI 0000 0004 0523 5263, Department of Ophthalmology and Optometry, , Paracelsus Medical University, ; Salzburg, Austria

Author information

Dimitrios Ilias Bolovis http://orcid.org/0000-0002-4935-2328

Article

Publisher ID: 5479

DOI: 10.1007/s00192-023-05479-4

PMC ID: 10415474

PubMed ID: 36786854

SO-VID: ea0991ac-852a-430e-b162-b24865e54521

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

History

Date received : 9 November 2022

Date accepted : 13 January 2023

Custom metadata

ScienceOpen disciplines: Obstetrics & Gynecology

Keywords: pelvic organ prolapse,unilateral pectineal suspension,robotic surgery

Data availability:

ScienceOpen disciplines: Obstetrics & Gynecology

Keywords: pelvic organ prolapse, unilateral pectineal suspension, robotic surgery

Retrospective analysis of apical prolapse correction by unilateral pectineal suspension: perioperative and short-term results

Read this article at

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

Related collections

Bacterial vaginosis and biofilm

Most cited references 24

Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence.

Epidemiology and outcome assessment of pelvic organ prolapse.

An International Urogynecological Association (IUGA) / International Continence Society (ICS) joint report on the terminology for female pelvic organ prolapse (POP).

Author and article information

Contributors

Journal

Affiliations

Author information

Article

History

Categories

Custom metadata

Comments

Comment on this article

Similar content 97

Cited by 3

Most referenced authors 210