ArticleInternational urogynecology journal2018
Vaginal hysterectomy with apical fixation and anterior vaginal wall repair for prolapse: surgical technique and medium-term results.
Article in International urogynecology journal, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 11 citations in OpenAlex.
- Double-layered anterior colporrhaphy (DAC)-video and mid-term follow-up of 60 patients.International urogynecology journal · 2023Article
- Comparison of High Uterosacral and Sacrospinous Ligament Suspension Surgeries for the Treatment of Pelvic Organ Prolapse in Women.Advanced biomedical research · 2023Article
- Clinical Efficacy of LSC and TVT-O for Stress Urinary Incontinence Complicated with Pelvic Organ Prolapse and Factors Influencing Postoperative Urinary Function Recovery.Journal of healthcare engineering · 2022Article
- Back to the future: vaginal hysterectomy and Campbell uterosacral ligaments suspension for urogenital prolapse.International urogynecology journal · 2021Article
- Current Role of Hysterectomy in Pelvic Floor Surgery: Time for Reappraisal? A Review of Current Literature and Expert Discussion.BioMed research international · 2021Review
- Surgical Outcomes and Feasibility of Transvaginal Sacrospinous Ligament Fixation through Anterior Approach for Women with Pelvic Organ Prolapse.Journal of mid-life healthArticle
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5 authors at 2 institutions in 1 country.
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Abstract
introduction and hypothesisStabilization of the vaginal apex (level 1) is an important component of operations to correct pelvic organ prolapse (POP). We report functional and anatomical results and patient-reported outcomes of our technique of vaginal vault fixation at the time of vaginal hysterectomy.
methodsOne hundred and nine patients-mean 69 years, range 50.4-83.8; body mass index (BMI) 26.3, range 17.7-39.5-with symptomatic stage 2-3 uterine prolapse combined with stage 3-4 cystocele underwent vaginal hysterectomy with anterior vaginal wall repair; the apex was formed with high closure of the peritoneum and incorporation of the uterosacral and round ligaments. Only absorbable sutures were used. Follow-up included clinical examination with Pelvic Organ Prolapse Quantification system (POP-Q) scoring, introital ultrasonography, quality of life (QoL) Likert scale, and the German Pelvic Floor Questionnaire.
resultsSeventy patients (64%) were available for a follow-up after a mean of 2.8 years (range, 1.6-4.2). At follow-up, point C was stage 0 in 55 (78.6%) women and stage 1 in 15 (21.4%). The anterior vaginal wall was stage 0 or 1 in 35 (50%), stage 2 (no cystocele beyond the hymen) in 34 (49%), and stage 3 in 1 (1.4%). Vaginal length (VL) was 9 cm. Four women (4%) were reoperated for prolapse: two for recurrent anterior compartment prolapse and two for de novo rectocele. Postvoid residuals >150 ml were seen in 21(30%) patients preoperatively and resolved postoperatively in 20. Urgency occurred in nine (13%), stress urinary incontinence (SUI) in ten (14%), and nocturia in 19 (27%). No patient had discomfort at the vaginal vault and 62 patients (87%) reported improved QoL, which did not correlate with anatomical results. Cystocele ≥ 2° at follow-up was associated with BMI >25 (p = 0.03).
conclusionsOur surgical technique without permanent material offers good apical support and functional and subjective results. Anatomical improvement was achieved in all cases of cystocele repair. Recurrent cystoceles are often asymptomatic.
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