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

Unger, Cecile A

Barber, Matthew D

Walters, Mark D

Paraiso, Marie Fidela R

Ridgeway, Beri

Jelovsek, J Eric

United States

2017-08-01T13:22:32Z

2017-08-01T13:22:32Z

2017-08-01

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.

https://www.ncbi.nlm.nih.gov/pubmed/27636212

2154-4212

https://hdl.handle.net/10161/15115

eng

Ovid Technologies (Wolters Kluwer Health)

Female Pelvic Med Reconstr Surg

10.1097/SPV.0000000000000313

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

Journal article

Jelovsek, J Eric|0000-0002-7196-817X

https://www.ncbi.nlm.nih.gov/pubmed/27636212

188

194

3

Clinical Science Departments

Duke

Obstetrics and Gynecology

Obstetrics and Gynecology, Urogynecology

School of Medicine

Published

23