Pelvic organ prolapse surgery following hysterectomy with benign indication: a national cohort study in Taiwan

Huang, Huei‐Kai; Ding, Dah‐Ching

doi:10.1007/s00192-018-3689-0

Cited by 9 publications

(14 citation statements)

References 19 publications

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“…Vaginal hysterectomies with suspension for treating POP lead to substantially higher rates of POP surgery than does the uterus preserving Manchester operation 1,2 . Likewise, a higher risk of POP surgery is found for hysterectomized women compared to non-hysterectomized women in studies of parous women 3,4 . This raises the question of whether the uterus protects against POP.…”

Section: Introductionmentioning

confidence: 98%

Pelvic organ prolapse following hysterectomy on benign indication: a nationwide, nulliparous cohort study

Husby

Gradel

Klarskov

2022

American Journal of Obstetrics and Gynecology

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Section: Introductionmentioning

confidence: 98%

Pelvic organ prolapse following hysterectomy on benign indication: a nationwide, nulliparous cohort study

Husby

Gradel

Klarskov

2022

American Journal of Obstetrics and Gynecology

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“…Urodynamic studies are also not sensitive to detect subtle differences in urinary function [27]. Furthermore the association between clinical symptoms and urodynamics are poor [28]. Therefore, one may question the relevance of urodynamic testing rather than relying on patient reported outcomes by way of validated questionnaires.…”

Section: Discussionmentioning

confidence: 99%

“…Huang and Ding found that the risk of prolapse was doubled following hysterectomy over 10-years [28]. Observational studies show that the risk of vault prolapse is higher with VH and LAVH which is probably due to the fact that these patients would have had some degree of pelvic floor weakness which would have contributed to the decision to undergo a vaginal procedure [29].…”

Section: Discussionmentioning

confidence: 99%

Vaginal, sexual and urinary symptoms following hysterectomy: a multi-centre randomized controlled trial

Ekanayake

Pathmeswaran

Herath

et al. 2020

womens midlife health

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Background: Hysterectomy is the most common major gynaecological procedure. The aim of this study was to study vaginal, sexual and urinary symptoms following total abdominal hysterectomy (TAH), non-descent vaginal hysterectomy (NDVH) and total laparoscopic hysterectomy (TLH) in a low resource setting. Methods: A multi-centre randomized controlled trial (RCT) was conducted in two public sector hospitals in Sri Lanka. Participants were patients requiring hysterectomy for non-malignant uterine causes. Exclusion criteria were uterus> 14 weeks, previous pelvic surgery, medical illnesses which contraindicated laparoscopic surgery, and those requiring incontinence surgery or pelvic floor surgery. Vaginal, sexual function and urinary symptoms were assessed by the validated translations of ICIQ-VS and ICIQ-FLUTS questionnaires. Post-operative improvement (pre-operativepost-operative) was assessed.Results: There was an improvement (median (IQ1-IQ3) in vaginal symptoms [TAH 6(2-8) vs 4(0-8), p < 0.001; NDVH 6(4-8.5) vs 5(0-8), p < 0.001; TLH 4(2-10.5) vs 4(0-10), p < 0.001], urinary flow symptoms [TAH 2(1-4) vs 1 (0-3), p < 0.001; NDVH 3 (2-5) vs 2 (0.5-4), p < 0.001; TLH 1(1-4) vs 1(0-3), p < 0.05], urinary voiding symptoms [TAH 0(0-0) vs 0(0-0), p = 0.20; NDVH 0(0-1) vs 0(0-0.8), p < 0.05; TLH 0(0-0) vs 0(0-0), p < 0.05] and urinary incontinence symptoms [TAH 0(0-2) vs 0(0-2), p = 0.06; NDVH 0(0-3) vs 0(0-3), p < 0.001; TLH 0(0-3) vs 0(0-2), p < 0.05] at 1-year (TAH n = 47, NDVH n = 45, TLH n = 47). There was an improvement in sexual symptoms only in the TLH group [TAH 0(0-11.5) vs 0(0-14), p = 0.08); NDVH 0(0-0) vs 0(0-0), p = 0.46; TLH 0(0-0) vs 0(0-4), p < 0.05]. There was no significant difference among the three different routes in terms of vaginal symptoms score [TAH 2 (0-2), NDVH 0 (0-2), TLH 0 (0-2), p = 0.33], sexual symptoms [TAH 0 (0-0), NDVH 0 (0-0), TLH 0 (0-0), p = 0.52], urinary flow symptoms [TAH 0 (0-1), NDVH 0 (0-1), TLH 0 (0-2), p = 0.56], urinary voiding symptoms [TAH 0 (0-0), NDVH 0 (0-0), TLH 0 (0-0), p = 0.64] and urinary incontinence symptoms [TAH 0 (0-0), NDVH 0 (0-1), TLH 0 (0-1), p = 0.35] at 1-year.Conclusions: There was a post-operative improvement in vaginal symptoms and urinary symptoms in all three groups. There was no significant difference in pelvic organ symptoms between the three routes; TAH, NDVH and TLH.Trial registration: Sri Lanka clinical trials registry, SLCTR/2016/020 and the International Clinical Trials Registry Platform, U1111-1194-8422, on 26 July 2016. Available from: http://slctr.lk/trials/515

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“…5 Vaginal hysterectomy has been linked to an increased risk for POP surgery later in life. 6,7 By definition, apical prolapse, which can be graded by the Pelvic Organ Prolapse Quantification system (POP-Q) classification, is described as a descent of the uterus, the vaginal vault or the cervix after a total/subtotal hysterectomy. 8 In surgical repair of POP, the recurrence rate is about 30% and the importance of apical support was recently highlighted.…”

Section: Introductionmentioning

confidence: 99%

“…Age, parity, obesity and chronic lung conditions are other risk factors in the development of pelvic organ prolapse (POP) 5 . Vaginal hysterectomy has been linked to an increased risk for POP surgery later in life 6,7 …”

Section: Introductionmentioning

confidence: 99%

Vaginal vault prolapse and recurrent surgery: A nationwide observational cohort study

Brunes

Drca

et al. 2022

Acta Obstet Gynecol Scand

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Introduction In surgical repair of pelvic organ prolapse the recurrence rate is about 30% and the importance of apical support was recently highlighted. In surgical randomized controlled studies, the external validity can be compromised because the surgical outcomes often depend on surgical volume. Therefore, we sought to study outcomes of surgical treatment in patients with vaginal vault prolapse in a nationwide setting with a variety of surgical volumes. Material and methods This is a nationwide cohort study. All patients with a vaginal vault prolapse undergoing surgery, between January 1, 2015 and December 31, 2018, were identified from the Swedish National Quality Register of Gynecological Surgery, GynOp. The primary outcome was the frequency of recurrent pelvic organ prolapse surgery within 2 years postoperatively. Secondary outcomes included patient‐reported vaginal bulging, operative time, estimated blood loss and 1‐year postoperative complications. Results In 1812 patients with vaginal vault prolapse, 538 (30%) had a sacrospinous ligament fixation (SSLF) with graft, 441 (24%) underwent SSLF without graft, and 200 (11%) underwent minimally invasive sacrocolpopexy (SCP) or sacrocervicopexy (SCerP). A significantly higher proportion of patients undergoing recurrent pelvic organ prolapse surgery was seen in SSLF without graft than in SSLF with graft (adjusted odds ratio [aOR] 2.2, 95% CI 1.4–3.6). Patient‐reported sensation of vaginal bulging 1 year after surgery was higher in the SSLF group without graft than in the SSLF group with graft (aOR 1.9, 95% CI 1.3–2.8) and in the SCP/SCerP group (aOR 2.0, 95% CI 1.1–3.4). Finally, we found a significantly higher rate of complications 1 year after surgery in SSLF without graft (aOR 2.3, 95% CI 1.2–4.2) and in SSLF with graft (aOR 2.2, 95% CI 1.2–4.2) compared with SCP/SCerP. Conclusions In patients with vaginal vault prolapse, SSLF without graft was associated with a higher frequency of recurrent pelvic organ prolapse surgery compared with SSLF with graft, and a higher subjective relapse rate compared with SCP/SCerP and SSLF with graft. Additionally, the complication rate 1 year after primary surgery was higher in SSLF both with and without graft than in SCP/SCerP.

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Pelvic organ prolapse surgery following hysterectomy with benign indication: a national cohort study in Taiwan

Abstract: Hysterectomy may increase the risk of subsequent POP surgery, and various hysterectomy techniques, particularly VH and LAVH, may increase the risk of subsequent POP surgery.

Cited by 9 publications

References 19 publications

Pelvic organ prolapse following hysterectomy on benign indication: a nationwide, nulliparous cohort study

Pelvic organ prolapse following hysterectomy on benign indication: a nationwide, nulliparous cohort study

Vaginal, sexual and urinary symptoms following hysterectomy: a multi-centre randomized controlled trial

Vaginal vault prolapse and recurrent surgery: A nationwide observational cohort study

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