Long-term experience of vaginal vault prolapse prevention at hysterectomy time by modified McCall culdoplasty or Shull suspension: Clinical, sexual and quality of life assessment after surgical intervention

Schiavi, Michele Carlo; Savone, Delia; Mascio, Daniele Di; Tucci, Chiara Di; Perniola, Giorgia; Zullo, Marzio Angelo; Muzii, Ludovico; Panici, Pierluigi Benedetti

doi:10.1016/j.ejogrb.2018.02.025

Cited by 25 publications

(22 citation statements)

References 32 publications

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“…Our results are consistent with those reported in a small number of previous studies that directly compared laparoscopic and transabdominal hysterectomy in women with benign (31)(32)(33)(34)(35) or malignant (36,37) uterine disease. Our analysis identified a higher incidence of sexual dysfunction after hysterectomy than some previous studies (10)(11)(12)(13)(14)(15)(16). However, it should be noted that the quality of female sexual life before and after hysterectomy might be affected by numerous factors such as age, ethnicity, family structure, psychologic factors (including body esteem and relationship quality), socioeconomic status and educational background (20,22,38,39).…”

Section: Discussionsupporting

confidence: 44%

“…There is also evidence that hysterectomy can lead to changes in sexual function, with differing effects depending on whether the underlying condition being treated is benign or malignant (8,9). Most studies have reported that hysterectomy for benign diseases results in an overall improvement in sexual function (10)(11)(12)(13)(14)(15), likely because of the alleviation of symptoms such as abnormal uterine bleeding and pelvic pain (16). However, around 20-40% of patients with benign disease experience a worsening of sexual function after hysterectomy (17)(18)(19), and one study even showed an overall worsening of sexual function (20).…”

Section: Introductionmentioning

confidence: 99%

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Sexual function after total laparoscopic hysterectomy or transabdominal hysterectomy for benign uterine disorders: a retrospective cohort

Wang

Xiao

2020

Braz J Med Biol Res

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The objective of this study was to evaluate changes in sexual function after total laparoscopic hysterectomy (TLH) or transabdominal hysterectomy (TAH). This retrospective cohort study included patients with benign uterine tumors that were divided into TLH group and TAH group based on the hysterectomy technique used. Baseline, intraoperative, and postoperative characteristics were compared between groups. Postoperative sexual function was assessed using the Brief Index of Sexual Functioning for Women. The TLH and TAH groups contained 119 patients (age, 51.5±6.1 years) and 126 patients (age, 50.0 ± 4.7 years), respectively. Baseline characteristics were comparable between groups, although uterine size was larger in the TAH group (Po0.001). Compared with the TAH group, the TLH group had a longer operative time (130.0 ± 36.2 vs 107.3 ± 28.5 min, Po0.001), lower pain index at 24 h (2.0 ± 1.6 vs 4.0 ± 2.6, Po0.001), and shorter hospitalization time (5.7 ± 1.1 vs 8.1 ± 1.2 days, Po0.001). Many patients in the TLH and TAH groups reported decreased satisfaction with their sexual life (67.5 and 56.0%, respectively), reduced frequency of sexual activity (70.1 and 56.0%, respectively), decreased libido (67.5 and 56.0%, respectively), orgasm dysfunction (42.9 and 42.9%, respectively), and increased dyspareunia (77.9 and 85.7%, respectively). However, there was no significant difference between groups in any of the indexes of postoperative sexual function (P40.05). Both TLH and TAH had comparable negative effects on sexual function in women treated for benign uterine tumors in China, with a decreased frequency of sexual activity, reduced libido, orgasm dysfunction, and increased dyspareunia.

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Section: Discussionsupporting

confidence: 44%

Section: Introductionmentioning

confidence: 99%

Sexual function after total laparoscopic hysterectomy or transabdominal hysterectomy for benign uterine disorders: a retrospective cohort

Wang

Xiao

2020

Braz J Med Biol Res

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“…Ureteric obstruction was seen almost exclusively in women having a modified McCall culdoplasty. Previous studies did not show that difference and rather showed equivocal safety compared with other suspension procedures [24,25].…”

Section: Discussionmentioning

confidence: 91%

Incidence and contributing factors of perioperative complications in surgical procedures for pelvic organ prolapse

2019

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Background Data on the incidence of perioperative complications of surgical procedures for pelvic organ prolapse (POP) and their contributing factors are limited, sometimes conflicting, and often mixed with other urogynecologic surgeries. Objectives To estimate the incidence and contributing factors for perioperative complications of POP procedures. Methods A cross-sectional study was carried out between November 2016 and June 2017. POP procedures of different approaches were included irrespective of the surgeon involved, type of surgery (primary or repeat), or concomitant hysterectomy or incontinence repair. Data on perioperative complications were recorded prospectively. Results A total of 366 women were included in the current analysis. The average age was 61.0 ± 13.4 years. The surgical procedures performed were vaginal (75.3%), abdominal (11.3%), or combined (13.4%). Approximately 18.2% of these procedures were repeat surgeries. A total of 38 (11.3%) women developed perioperative complications (3.6% severe and 7.7% minor). These included: 25 (7.4%) intraoperative complications (2.4% severe and 5.1% minor) and 17 (5.1%) postoperative complications (2.1% severe and 3.0% minor). In multivariate analysis, abdominal surgery and McCall culdoplasty were significant predictors of intraoperative complications (alone or when combined with other postoperative complications). On the other hand, concomitant hysterectomy and concomitant incontinence repair procedure were associated with higher postoperative complication rates while vaginal surgery had fewer postoperative complications. Conclusion There was a low rate of perioperative complications. Abdominal surgery and McCall culdoplasty showed higher intraoperative complications. These data should help in preoperative counseling and target ways to further decrease complication rates.

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“…reported a surgical success of 91% after 9 years, with 4.8% of bulging symptoms and no re‐operation for prolapse recurrence during the period of the study. Lastly, Schiavi et al . demonstrated 1% apical recurrence, 9.4% bulging symptoms, and 1.5% re‐operation rate for recurrence of prolapse after a median follow‐up of 8.9 years.…”

Section: Discussionmentioning

confidence: 96%

Long‐term outcomes and five‐year recurrence‐free survival curves after native‐tissue prolapse repair

Deo

Bernasconi

Cola

et al. 2019

Intl J Gynecology & Obste

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Objective: To evaluate the long-term objective and subjective outcomes to build recurrence-free survival curves after mesh-free uterosacral ligament suspension and to evaluate the long-term impact of prognostic factors on outcome measures. Methods:A retrospective study analyzed 5-year follow-up after repair of primary prolapse through high uterosacral ligament suspension. Bulging symptoms and postoperative prolapse stage II or above were considered subjective and objective recurrences, respectively. The cumulative proportion of relapse-free patients in time was analyzed by Kaplan-Meier curves.Results: A total of 353 women were analyzed. Five-year recurrence rates were 15.0% for objective recurrence, 13.0% for subjective recurrence, and 4.0% for the combined objective and subjective recurrences. Premenopausal status was shown to be a risk factor for anatomic (P=0.022), symptomatic (P=0.001), and combined (P=0.047) recurrence. Conversely, anterior repair was shown to be a protective factor for symptomatic (P=0.012) and combined (P=0.002) recurrence. Most of the recurrences occurred within 2 years after surgery. Conclusion:Long-term outcomes after high uterosacral ligament suspension were satisfactory. Premenopausal status and lack of anterior repair represented risk factors for recurrence in the long term. K E Y W O R D SLong-term follow-up; Native-tissue repair; Prolapse surgery; Recurrence; Risk factors; Uterosacral ligament suspension

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Long-term experience of vaginal vault prolapse prevention at hysterectomy time by modified McCall culdoplasty or Shull suspension: Clinical, sexual and quality of life assessment after surgical intervention

Cited by 25 publications

References 32 publications

Sexual function after total laparoscopic hysterectomy or transabdominal hysterectomy for benign uterine disorders: a retrospective cohort

Sexual function after total laparoscopic hysterectomy or transabdominal hysterectomy for benign uterine disorders: a retrospective cohort

Incidence and contributing factors of perioperative complications in surgical procedures for pelvic organ prolapse

Long‐term outcomes and five‐year recurrence‐free survival curves after native‐tissue prolapse repair

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