Pelvic organ prolapse and uterine preservation: a cohort study (POP-UP study)
Abstract Background Abdominal and laparoscopic sacro-colpopexy (LSC) is considered the standard surgical option for the management of a symptomatic apical pelvic organ prolapse (POP). Women who have their uterus, and for whom an LSC is indicated, can have a laparoscopic sacro-hysteropexy (LSH), a la...
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doaj-e9aee5ddeea64cff9427ac6b1bb2544c2021-02-21T12:19:44ZengBMCBMC Women's Health1472-68742021-02-012111910.1186/s12905-021-01208-5Pelvic organ prolapse and uterine preservation: a cohort study (POP-UP study)Daniel Gagyor0Vladimir Kalis1Martin Smazinka2Zdenek Rusavy3Radovan Pilka4Khaled M. Ismail5Department of Obstetrics and Gynaecology, Faculty of Medicine and Dentistry, Palacky University and Faculty HospitalBiomedical Center, Faculty of Medicine in Pilsen, Charles UniversityDepartment of Obstetrics and Gynecology, University HospitalBiomedical Center, Faculty of Medicine in Pilsen, Charles UniversityDepartment of Obstetrics and Gynaecology, Faculty of Medicine and Dentistry, Palacky University and Faculty HospitalBiomedical Center, Faculty of Medicine in Pilsen, Charles UniversityAbstract Background Abdominal and laparoscopic sacro-colpopexy (LSC) is considered the standard surgical option for the management of a symptomatic apical pelvic organ prolapse (POP). Women who have their uterus, and for whom an LSC is indicated, can have a laparoscopic sacro-hysteropexy (LSH), a laparoscopic supra-cervical hysterectomy and laparoscopic sacro-cervicopexy (LSCH + LSC) or a total laparoscopic hysterectomy and laparoscopic sacro-colpopexy (TLH + LSC). The main aim of this study was to compare clinical and patient reported outcomes of uterine sparing versus concomitant hysterectomy LSC procedures. Methods A retrospective analysis of clinical, imaging and patient reported outcomes at baseline, 3 and 12 months after LSH versus either LSCH + LSC or TLH + LSC between January 2015 and January 2019 in a tertiary referral urogynecology center in Pilsen, the Czech Republic. Results In total, 294 women were included in this analysis (LSH n = 43, LSCH + LSC n = 208 and TLH + LSC n = 43). There were no differences in the incidence of perioperative injuries and complications. There were no statistically significant differences between the concomitant hysterectomy and the uterine sparing groups in any of the operative, clinical or patient reported outcomes except for a significantly lower anterior compartment failure rate (p = 0.017) and higher optimal mesh placement rate at 12 months in women who had concomitant hysterectomy procedures (p = 0.006). Conclusion LSH seems to be associated with higher incidence of anterior compartment failures and suboptimal mesh placement based on postoperative imaging techniques compared to LSC with concomitant hysterectomy.https://doi.org/10.1186/s12905-021-01208-5LaparoscopicSacrocolpopexyCervicopexyHysteropexyLSCLSCH + LSC |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Daniel Gagyor Vladimir Kalis Martin Smazinka Zdenek Rusavy Radovan Pilka Khaled M. Ismail |
spellingShingle |
Daniel Gagyor Vladimir Kalis Martin Smazinka Zdenek Rusavy Radovan Pilka Khaled M. Ismail Pelvic organ prolapse and uterine preservation: a cohort study (POP-UP study) BMC Women's Health Laparoscopic Sacrocolpopexy Cervicopexy Hysteropexy LSC LSCH + LSC |
author_facet |
Daniel Gagyor Vladimir Kalis Martin Smazinka Zdenek Rusavy Radovan Pilka Khaled M. Ismail |
author_sort |
Daniel Gagyor |
title |
Pelvic organ prolapse and uterine preservation: a cohort study (POP-UP study) |
title_short |
Pelvic organ prolapse and uterine preservation: a cohort study (POP-UP study) |
title_full |
Pelvic organ prolapse and uterine preservation: a cohort study (POP-UP study) |
title_fullStr |
Pelvic organ prolapse and uterine preservation: a cohort study (POP-UP study) |
title_full_unstemmed |
Pelvic organ prolapse and uterine preservation: a cohort study (POP-UP study) |
title_sort |
pelvic organ prolapse and uterine preservation: a cohort study (pop-up study) |
publisher |
BMC |
series |
BMC Women's Health |
issn |
1472-6874 |
publishDate |
2021-02-01 |
description |
Abstract Background Abdominal and laparoscopic sacro-colpopexy (LSC) is considered the standard surgical option for the management of a symptomatic apical pelvic organ prolapse (POP). Women who have their uterus, and for whom an LSC is indicated, can have a laparoscopic sacro-hysteropexy (LSH), a laparoscopic supra-cervical hysterectomy and laparoscopic sacro-cervicopexy (LSCH + LSC) or a total laparoscopic hysterectomy and laparoscopic sacro-colpopexy (TLH + LSC). The main aim of this study was to compare clinical and patient reported outcomes of uterine sparing versus concomitant hysterectomy LSC procedures. Methods A retrospective analysis of clinical, imaging and patient reported outcomes at baseline, 3 and 12 months after LSH versus either LSCH + LSC or TLH + LSC between January 2015 and January 2019 in a tertiary referral urogynecology center in Pilsen, the Czech Republic. Results In total, 294 women were included in this analysis (LSH n = 43, LSCH + LSC n = 208 and TLH + LSC n = 43). There were no differences in the incidence of perioperative injuries and complications. There were no statistically significant differences between the concomitant hysterectomy and the uterine sparing groups in any of the operative, clinical or patient reported outcomes except for a significantly lower anterior compartment failure rate (p = 0.017) and higher optimal mesh placement rate at 12 months in women who had concomitant hysterectomy procedures (p = 0.006). Conclusion LSH seems to be associated with higher incidence of anterior compartment failures and suboptimal mesh placement based on postoperative imaging techniques compared to LSC with concomitant hysterectomy. |
topic |
Laparoscopic Sacrocolpopexy Cervicopexy Hysteropexy LSC LSCH + LSC |
url |
https://doi.org/10.1186/s12905-021-01208-5 |
work_keys_str_mv |
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