Evidence map›Paper›PMID 27858132›Full record

ArticleInternational urogynecology journal2017

Ligament shortening compared to vaginal colpopexy at the time of hysterectomy for pelvic organ prolapse.

Pamela S Fairchild, Neil S Kamdar, Emily R Rosen, Carolyn W Swenson, Dee E Fenner, John O DeLancey, Daniel M Morgan

Abstract readEvaluation Study
In one paragraph

Article in International urogynecology journal, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Pamela S FairchildUniversity of Michigan Female Pelvic Medicine and Reconstructive Surgery, Ann Arbor, MI, USA. pfairchi@gmail.com.
Neil S KamdarUniversity of Michigan Female Pelvic Medicine and Reconstructive Surgery, Ann Arbor, MI, USA.
Emily R RosenUniversity of Michigan Female Pelvic Medicine and Reconstructive Surgery, Ann Arbor, MI, USA.
Carolyn W SwensonUniversity of Michigan Female Pelvic Medicine and Reconstructive Surgery, Ann Arbor, MI, USA.
Dee E FennerUniversity of Michigan Female Pelvic Medicine and Reconstructive Surgery, Ann Arbor, MI, USA.
John O DeLanceyUniversity of Michigan Female Pelvic Medicine and Reconstructive Surgery, Ann Arbor, MI, USA.
Daniel M MorganUniversity of Michigan Female Pelvic Medicine and Reconstructive Surgery, Ann Arbor, MI, USA.

Funding

MICHIGAN INSTITUTE FOR CLINICAL AND HEALTH RESEARCH (MICHR) (UL1): (BPCA)UL1RR024986 · NCRR · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI SHANLEY, THOMAS P. · 2007 to 2011
$51.2M
Michigan Institute for Clinical and Health Research (MCHR)UL1TR000433 · NCATS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI MASHOUR, GEORGE ALEXANDER · 2012 to 2016
$49.9M
Which pelvic floor defects cause stress incontinence?P50HD044406 · NICHD · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI DELANCEY, JOHN O.L. · 2002 to 2017
$17.1M
University of Michigan WRHR Career Development ProgramK12HD065257 · NICHD · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI FENNER, DEE ELLEN · 2010 to 2019
$3.4M
NCATS NIH HHS UL1 TR000433NCRR NIH HHS UL1 RR024986NICHD NIH HHS K12 HD065257NICHD NIH HHS P50 HD044406
6 · The paper itself

Abstract

introduction and hypothesisThe performance of a colpopexy at the time of hysterectomy for pelvic organ prolapse is a potential indicator of surgical quality. However, vaginal colpopexy has not been directly compared with the classic technique of ligament shortening and reattachment. We sought to test the null hypothesis that there is no difference in prolapse recurrence between the techniques.

methodsWe performed a retrospective chart review of 330 vaginal hysterectomies performed for prolapse, comparing symptomatic and/or anatomic recurrence rates between patients having a vaginal colpopexy (uterosacral ligament suspension or sacrospinous ligament suspension) and those having ligament shortening and reattachment. Clinically relevant variables significantly associated with recurrence in a univariate analysis were used to create a multivariable logistic regression model to predict recurrence.

resultsWith a mean follow-up of 20 months, there was no significant difference between symptomatic and/or anatomic recurrence rates: 19.4 % of patients (41 of 211) having colpopexy vs. 11.8 % of patients (14 of 119) having ligament shortening (p = 0.07). Baseline prolapse stage was higher in patients having colpopexy (median 3, IQR 2 - 5) than in those having ligament shortening (median 2, IQR 1 - 3; p ≤ 0.0001). In the multivariable logistic regression analysis, the procedure performed was not associated with recurrence (OR 1.57, 95 % CI 0.79 - 3.12). A baseline prolapse of 4 cm or greater was associated with recurrence (OR 2.63, 95 % CI 1.32 - 5.22), as was the time since hysterectomy (OR 1.02 per month, 95 % CI 1.01 - 1.04).

conclusionsWhen compared with vaginal colpopexy, selective use of the ligament shortening technique at the time of vaginal hysterectomy was associated with similar rates of prolapse recurrence. Preoperative prolapse size was the factor most strongly associated with recurrence.

Indexed as

AgedColposcopyCombined Modality TherapyFemaleFollow-Up StudiesHumansHysterectomy, VaginalLigamentsMiddle AgedPelvic Organ ProlapseRecurrenceRetrospective StudiesSacrumTreatment OutcomeUterusApical supportColpopexyHysterectomy for prolapseRecurrence

Identifiers

PMID27858132
PMCPMC5435546

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.