Long-Term Effectiveness of Uterosacral Colpopexy and Minimally Invasive Sacral Colpopexy for Treatment of Pelvic Organ Prolapse.
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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https://hdl.handle.net/10161/15115Published Version (Please cite this version)
10.1097/SPV.0000000000000313Publication 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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Show full item recordScholars@Duke
Matthew Don Barber
Edwin Crowell Hamblen Distinguished Professor of Reproductive Biology and Family Planning
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
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