Transvaginal round-infundibulopelvic ligament colposuspension after vaginal hysterectomy in high-grade uterovaginal prolapse: 11-year outcome

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dc.authorid0000-0001-6733-592Xen_US
dc.authorid0000-0002 -0745-0907
dc.authorid0000-0002-8929-6973
dc.authorid0000-0002-2176-7863
dc.contributor.authorEkici, Mustafa Ayhan
dc.contributor.authorÇetin, Çaglar
dc.contributor.authorKayar, Batuhan
dc.contributor.authorAlbayrak, Ömür
dc.contributor.authorTopçuoğlu, Mehmet Ata
dc.contributor.authorUral, Ülkü Mete
dc.date.accessioned2021-06-23T19:53:57Z
dc.date.available2021-06-23T19:53:57Z
dc.date.issued2020
dc.departmentBAİBÜ, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümüen_US
dc.description.abstractObjective: To interpret the long-term outcomes of transvaginal round-infundibulopelvic ligament colposuspension after vaginal hysterectomy in patients with stage 3-4 uterovaginal prolapse. Study design: This retrospective case-control study from 2007 to 2016 analysed patients' medical records and evaluated gynaecological examinations over 11 years of follow-up. One hundred and forty-three patients who underwent transvaginal round-infundibulopelvic ligament colposuspension after vaginal hysterectomy were evaluated. The prespecified primary outcome evaluated at 11-year follow-up was apical prolapse of stage 2 or higher evaluated by the Pelvic Organ Prolapse Quantification System (POP Q), in combination with bothersome bulge symptoms or repeat surgery for recurrent apical prolapse. The secondary outcome was overall anatomical failure (recurrent prolapse of stage 2 or higher in apical, anterior or posterior compartment). The rate of recurrence of apical prolapse was compared between groups using the McNemar test. Results: The mean (+/- standard deviation) follow-up period was 88.15 +/- 2.519 months (95 % confidence interval 83.17-93.13). The pre-operative diagnoses were stage 3 uterovaginal prolapse in 23 (16.08 %) patients, stage 4 uterovaginal prolapse in 120 (83.91 %) patients, rectocele in 119 (83.21 %) patients, cystocele in 138 (96.50 %) patients and stress urinary incontinence in 53 (37.06 %) patients. Ten (8.33 %) patients with stage 4 uterovaginal prolapse developed postoperative apical prolapse, whereas none of the patients with stage 3 uterovaginal prolapse developed postoperative apical prolapse. Postoperatively, the POP-Q stages of apical prolapse were significantly lower compared with pre-operatively (p < 0.001). Postoperatively, the apical prolapse rate was 7.0 %, the recurrent cystocele rate was 2.07 %, the recurrent rectocele rate was 5.5 %, and the recurrent stress urinary incontinence rate was 18.87 %. Overall, postoperative anatomical failure occurred in 21 of 143 (14.68 %) women. One (0.69 %) patient developed perioperative bladder perforation, two (1.39 %) patients experienced voiding difficulty, and eight (5.59 %) patients experienced vaginal spotting. Conclusion: Transvaginal round-infundibulopelvic ligament colposuspension during vaginal hysterectomy is an effective and useful method that reduces the rate of postoperative apical prolapse in patients with high-grade uterovaginal prolapse. (C) 2020 Elsevier B.V. All rights reserved.en_US
dc.identifier.doi10.1016/j.ejogrb.2020.06.028
dc.identifier.endpage180en_US
dc.identifier.issn0301-2115
dc.identifier.issn1872-7654
dc.identifier.pmid32622101en_US
dc.identifier.scopus2-s2.0-85087130537en_US
dc.identifier.scopusqualityN/Aen_US
dc.identifier.startpage174en_US
dc.identifier.urihttps://doi.org/10.1016/j.ejogrb.2020.06.028
dc.identifier.urihttps://hdl.handle.net/20.500.12491/10348
dc.identifier.volume252en_US
dc.identifier.wosWOS:000573036000027en_US
dc.identifier.wosqualityQ3en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.institutionauthorEkici, Mustafa Ayhan
dc.institutionauthorUral, Ülkü Mete
dc.institutionauthorKayar, Batuhan
dc.institutionauthorAlbayrak, Ömür
dc.institutionauthorTopçuoğlu, Mehmet Ata
dc.language.isoenen_US
dc.publisherElsevieren_US
dc.relation.ispartofEuropean Journal Of Obstetrics & Gynecology And Reproductive Biologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectVaginal Hysterectomyen_US
dc.subjectUterovaginal Prolapseen_US
dc.subjectColposuspensionen_US
dc.subjectInfundibulopelvicen_US
dc.subjectLigamenten_US
dc.subjectApical Prolapseen_US
dc.titleTransvaginal round-infundibulopelvic ligament colposuspension after vaginal hysterectomy in high-grade uterovaginal prolapse: 11-year outcomeen_US
dc.typeArticleen_US

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