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Long-Term Effectiveness of Uterosacral Colpopexy and Minimally Invasive Sacral Colpopexy for Treatment of Pelvic Organ Prolapse.

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Date
2017-08-01
Authors
Unger, Cecile A
Barber, Matthew D
Walters, Mark D
Paraiso, Marie Fidela R
Ridgeway, Beri
Jelovsek, J Eric
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Abstract
OBJECTIVES: The objective of this study was to estimate rates of recurrent pelvic organ prolapse (POP) 6 years after patients underwent transvaginal uterosacral colpopexy, or laparoscopic or robotic sacral colpopexy at a large tertiary care center. We hypothesized that recurrence rates would be higher than those previously reported. METHODS: This is a retrospective study of women who underwent uterosacral colpopexy, laparoscopic, and robotic sacral colpopexy for treatment of POP between 2006 and 2012. A composite outcome for recurrent POP was defined as subjective failure (vaginal bulge symptoms), objective failure (prolapse to or beyond the hymen), or any retreatment for POP (reoperation or use of a pessary). Kaplan-Meier survival curves were generated from each patient's date of follow-up, and parametric survival modeling was used to estimate recurrent POP over 6 years. Annual estimated recurrence rates by type of colpopexy are reported using the composite and individual definitions for recurrent POP. RESULTS: One thousand three hundred eighty-one subjects met inclusion criteria: 983 (71.1 %) uterosacral, 256 (18.5%) laparoscopic, and 142 (11.2%) robotic colpopexies. Median (range) months to failure using composite recurrence were as follows: uterosacral, 17.1 (7.6-41); laparoscopic, 10.1 (4.7-25.1); robotic, 9.7 (1.6-17.2). By year 6 in the model, the estimated composite recurrence rates for the uterosacral colpopexy, robotic, and laparoscopic sacral colpopexy groups were 43%, 49%, and 57%, respectively. CONCLUSIONS: Estimated recurrence rates for uterosacral ligament colpopexy, laparoscopic, and robotic sacral colpopexy may be as high as 40% to 60% 6 years after surgery.
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Journal article
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https://hdl.handle.net/10161/15115
Published Version (Please cite this version)
10.1097/SPV.0000000000000313
Publication Info
Unger, Cecile A; Barber, Matthew D; Walters, Mark D; Paraiso, Marie Fidela R; Ridgeway, Beri; & Jelovsek, J Eric (2017). Long-Term Effectiveness of Uterosacral Colpopexy and Minimally Invasive Sacral Colpopexy for Treatment of Pelvic Organ Prolapse. Female Pelvic Med Reconstr Surg, 23(3). pp. 188-194. 10.1097/SPV.0000000000000313. Retrieved from https://hdl.handle.net/10161/15115.
This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
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Scholars@Duke

Barber

Matthew Don Barber

Edwin Crowell Hamblen Distinguished Professor of Reproductive Biology and Family Planning
Jelovsek

John E Jelovsek

Professor of Obstetrics and Gynecology
Dr. Jelovsek is the Director of Data Science for Women’s Health in Department of Obstetrics & Gynecology (OBGYN) at Duke University. He is Board Certified in OBGYN by the American Board of OBGYN and Board Certified in Female Pelvic Medicine & Reconstructive Surgery by the American Board of OBGYN and American Board of Urology. He currently practices Female Pelvic Medicine and Reconstructive Surgery (FPMRS). He has expertise in the development and validation of “individualiz
Alphabetical list of authors with Scholars@Duke profiles.
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