Outcomes of sacrocolpopexy/sacrohysteropexy with mesh placement targeted to affected compartment

Rušavý, Zdeněk; Najib, Bernard; Abdelkhalek, Yara; Grinstein, Ehud; Gluck, Ohad; Deval, Bruno

doi:10.1016/j.ejogrb.2022.03.037

Cited by 3 publications

(2 citation statements)

References 24 publications

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“…Sample sizes of 56 and 28 patients in the LSC/SCH and LSC/UP groups respectively provided a post-hoc power of 45% to detect CF in the two groups (3.6% and 10.7% respectively), based on a 5% type I error rate. Variables included in the PSM were selected based on prior studies [ 16 – 20 ] and factors that may clinically influence outcomes. All covariates (potential confounders) affecting the outcomes were selected.…”

Section: Methodsmentioning

confidence: 99%

“…A comparison between LSC/UP and LSC/SCH was performed using PSM (1:2) to evaluate CF. The UP and SCH cohorts were matched at baseline according to age [ 16 ], BMI [ 17 ], CCI, vaginal parity, POP-Q stage [ 18 ], follow-up, Ba measurement [ 19 ], and anterior or anterior and posterior mesh implants [ 20 ]. We used the Kaplan–Meier method and log-rank test to compare the CF rates of the matched groups.…”

Section: Methodsmentioning

confidence: 99%

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Comparison of outcomes of laparoscopic sacrocolpopexy with concomitant supracervical hysterectomy or uterine preservation

et al. 2023

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Introduction and hypothesis Sacrocolpopexy was traditionally performed for post-hysterectomy prolapse or during concurrent hysterectomy. Sacrocolpopexy outcome with uterine preservation is poorly investigated. This study compared outcomes of laparoscopic sacrocolpopexy with concurrent supracervical hysterectomy or uterine preservation. Methods This retrospective study compared data of patients with pelvic organ prolapse who underwent laparoscopic sacrocolpopexy with uterine preservation with the data of controls who underwent laparoscopic sacrocolpopexy with supracervical hysterectomy. We analyzed composite failure in uterine preservation versus concurrent supracervical hysterectomy (primary objective) and evaluated factors associated with the primary outcome of composite failure after laparoscopic sacrocolpopexy with preservation or supracervical hysterectomy (secondary objective). Composite failure was defined as subjective bulge symptoms, reoperation, or anatomical prolapse. Cox models indicated time to composite failure as an endpoint. Results Of 274 patients, 232 underwent laparoscopic sacrocolpopexy with supracervical hysterectomy and 42 underwent laparoscopic uterine preservation. After propensity score matching (ratio: 2, for the laparoscopic sacrocolpopexy with supracervical hysterectomy group), 56 patients (24.1%) were in the supracervical hysterectomy group and 28 (66.7%) in the uterine preservation group. All patients underwent 24 months of follow-up. The composite failure rates were 10.7% for supracervical hysterectomy and 3.6% for preservation (p=0.87). The mean estimated blood loss was 10 ml (preservation, 10.0 ml [5.0–10.0] versus supracervical hysterectomy, 10.0 ml [10.0–15.0]; p=0.007). In the Cox proportional hazards model, higher preoperative body mass index and the point Ba increased composite failure risk. Conclusions Although not statistically significant, composite failure in the two techniques is likely clinically meaningful.

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Section: Methodsmentioning

confidence: 99%