Risk factors for ureteral occlusion during transvaginal uterosacral ligament suspension

Jackson, Elisha; Bilbao, Jorge; Mulla, Zuber D.; Mallett, Veronica; Montoya, T. Ignacio

doi:10.1007/s00192-015-2770-1

Cited by 19 publications

(14 citation statements)

References 22 publications

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“…19 There is a possibility that we have under-reported these complications if patients sought care elsewhere in their postoperative course, which is a limitation of a retrospective study design. Ureteral occlusion 20 and postoperative pain 21 are the most common adverse events experienced by women undergoing uterosacral ligament suspension. Although, number of sutures and suture type have not necessarily been correlated with an increased risk of ureteral kinking 19 or pain, our overall lower number of suspension sutures may be a reason for our lower number of complications compared to what is reported in the literature.…”

Section: Discussionmentioning

confidence: 99%

Vaginal Uterosacral Ligament Suspension: A Retrospective Cohort of Absorbable and Permanent Suture Groups

Bradley¹,

Bickhaus²,

Amundsen³

et al. 2018

Female Pelvic Med Reconstr Surg

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Section: Discussionmentioning

confidence: 99%

Vaginal Uterosacral Ligament Suspension: A Retrospective Cohort of Absorbable and Permanent Suture Groups

Bradley¹,

Bickhaus²,

Amundsen³

et al. 2018

Female Pelvic Med Reconstr Surg

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“…This has traditionally been accomplished with SSLF or other vaginal procedures such as uterosacral ligament suspension (USLS). USLS may be easier to perform than SSLF, with less risk of hemorrhage or infection, but does carry a higher risk of ureteral injury especially in patients with concomitant anterior colporrhaphy (22). Moreover, USLS is less practical in treating patients with post-hysterectomy vault prolapse.…”

Section: Discussionmentioning

confidence: 99%

Safety and short term outcomes of a new truly minimally-invasive mesh-less and dissection-less anchoring system for pelvic organ prolapse apical repair

et al. 2017

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Objective To evaluate the safety and short term outcomes of a new, truly minimally-invasive, mesh-less and dissection-less anchoring system for pelvic floor apical repair.Methods A prospective study was conducted using the NeuGuide™ device system for pelvic floor apical repair. The primary effectiveness outcome was centro-apical pelvic floor prolapse by POP-Q after six months. The primary safety outcome was intra-operative, immediate (first 48 h) post-operative complications and adverse effects after six months. A standardized questionnaire (UDI-6) to assess quality of life at entry and during follow-up visits was used. Patients’ six months-follow-up and evaluation are reported.Results The mean age of the study population (n=10) was 63.8±12.0 years. All patients had a previous prolapse surgery. Five had a previous hysterectomy and two had stress urinary incontinence symptoms. During surgery six patients had a concurrent colporrhaphy. There was no injury to the bladder, rectum, pudendal nerves, or major pelvic vessels and no febrile morbidity was recorded. At six months, no cases of centro-apical recurrence were noted. Patients were satisfied with the procedure and had favorable quality of life scores. Using the UDI-6 questionnaire an improvement, in all domains was seen. Moreover, although the sample size was small, the improvement in urge and overflow incontinence related domains were demonstrated to be statistically significant.Conclusions This new NeuGuide™ device allows rapid and safe introduction of a suspending suture through the sacrospinous ligament and makes sacrospinous ligament fixation easy to perform, while avoiding dissection and mesh complications.

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“…Several studies have shown that the rate of ureteral obstructions after SSLF was lower than HUS, while the rate of ureteral obstructions after HUS was 3.7-9% [22]. Jackson [23] et al found that ureteral occlusion was more frequent in those patients undergoing concomitant anterior colporrhaphy. In this study, we used a concomitant pubocervical fascia reconstruction during LSSLF plicated anterior vaginal wall that may pull the ureters toward the anterior vaginal wall, which in turn shortens the distance from the vaginal stump to ureters, and increases the risk of ureteral damage.…”

Section: Sacrospinous Ligament Xation (Sslf)mentioning

confidence: 99%

Medium-Term Outcomes of Laparoscopic Pubocervical Fascia Reconstruction and Sacrospinous Ligament Fixation for Pelvic Organ Prolapse

Zhu¹,

Xiao²,

Chen³

et al. 2020

Preprint

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Background: The aim of this study was to investigate the medium-term outcomes of laparoscopic pubocervical fascia reconstruction and sacrospinous ligament fixation with a posterior approach for severe pelvic organ prolapse (POP). Methods: A total of 129 patients with severe POP quantitation stage III-IV who underwent laparoscopic pubocervical fascia reconstruction and sacrospinous ligament fixation with a posterior approach at Sir Run Run Shaw Hospital College of Medicine, Zhejiang University, Hangzhou, China between September 2014 and December 2018 were enrolled in this study. One hundred twenty-four patients were followed up for at least 1 year. The results and complications were recorded. Data were retrospectively reviewed. Results: All the patients underwent laparoscopic pubocervical fascia reconstruction and sacrospinous ligament fixation with a posterior approach. The average follow-up time was 32.27±12.90 months. The objective cure rate for those who underwent hysterectomy was 91.7 % (100/109), and no patient experienced apical vaginal prolapse. The objective cure rate for those who retained uterus was 66.67% (10/15). Suture-related complications were recorded.Conclusions: Laparoscopic pubocervical fascia reconstruction and sacrospinous ligament fixation with the posterior approach is a safe, minimally invasive, and effective method for patients with severe POP. Long-term follow-up is required to confirm the clinical effects.

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Risk factors for ureteral occlusion during transvaginal uterosacral ligament suspension

Abstract: During transvaginal USLS, performance of a concomitant anterior colporrhaphy increased the risk of ureteral occlusion, while the use of a suture-capturing device for suspension suture placement was associated with decreased risk.

Cited by 19 publications

References 22 publications

Vaginal Uterosacral Ligament Suspension: A Retrospective Cohort of Absorbable and Permanent Suture Groups

Vaginal Uterosacral Ligament Suspension: A Retrospective Cohort of Absorbable and Permanent Suture Groups

Safety and short term outcomes of a new truly minimally-invasive mesh-less and dissection-less anchoring system for pelvic organ prolapse apical repair

Medium-Term Outcomes of Laparoscopic Pubocervical Fascia Reconstruction and Sacrospinous Ligament Fixation for Pelvic Organ Prolapse

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