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Apikal Pelvik Organ Prolapsusunda Sakrospinöz Ligaman Fiksasyonu ve Uterosakral Ligaman Fiksasyonu Ameliyatlarının Uzun Dönem Sonuçlarının Karşılaştırılması

Year 2018, Volume: 10 Issue: 3, 381 - 386, 23.10.2018
https://doi.org/10.18521/ktd.462769

Abstract

Amaç: Bu çalışmada, apikal pelvik organ prolapsusu (POP) tedavisinde kullanılan sakrospinöz ligaman fiksasyonu (SSLS) ve uterosakral ligaman fiksasyonu (ULS) ameliyatlarının uzun dönem sonuçlarını karşılaştırmayı amaçladık.

Gereç ve Yöntem: Retrospektif çalışmamıza apikal POP tanısı almış 52 hasta dahil edildi. Bu hastaların yirmisi ULS (Grup 1) ile, otuzikisi bilateral SSLS (Grup 2) ameliyatı ile tedavi edildi. Hastane bilgi sisteminden operasyon verilerine, 12. ve 36. aydaki muayene bilgilerine, hasta memnuniyet oranları, objektif ve sübjektif kür oranları ve komplikasyonlara ulaşıldı.

Bulgular: Objektif kür oranları, 12. ayda grup 1’in %80, Grup 2’nin %78.1 iken; 36. ayda Grup 1’in %70, Grup 2’nin %71.8 bulundu (p>0.05). Subjektif kür oranları, 12. ayda grup 1’in %100, grup 2’nin %87.4 iken; 36. ayda grup 1’in %100, grup 2’nin %84.1 olarak saptandı (p>0.05). Memnuniyeti çok olan hastalar ULS grubunda SSLS grubuna kıyasla anlamlı oranda fazla bulundu ancak memnun olan tüm hastalar (çok memnun ve büyük oranda memnun) ile memnun olmayanlar kıyaslandığında, gruplar arası istatistiksel olarak anlamlı bir fark bulunmadı (p>0.05).

Sonuç: Apikal pelvik organ prolapsusu hastalarında vaginal olarak sık uygulanan iki yöntem olan ULS ve SSLS’nin, başarı oranları ve hasta memnuniyetleri kıyaslandığında birbirine üstün olmadığı sonucuna varıldı.

References

  • 1. Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub‐committee of the International Continence Society. Neurourology and urodynamics. 2002;21(2):167-78.
  • 2. Lowder JL, Ghetti C, Nikolajski C, Oliphant SS, Zyczynski HM. Body image perceptions in women with pelvic organ prolapse: a qualitative study. American journal of obstetrics and gynecology. 2011;204(5):441.e1-5.
  • 3. Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL. Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstetrics and gynecology. 1997;89(4):501-6.
  • 4. Smith FJ, Holman CD, Moorin RE, Tsokos N. Lifetime risk of undergoing surgery for pelvic organ prolapse. Obstetrics and gynecology. 2010;116(5):1096-100.
  • 5. Barber MD, Maher C. Epidemiology and outcome assessment of pelvic organ prolapse. International urogynecology journal. 2013;24(11):1783-90.
  • 6. Alas AN, Anger JT. Management of apical pelvic organ prolapse. Current urology reports. 2015;16(5):33.
  • 7. Maher C, Feiner B, Baessler K, Christmann-Schmid C, Haya N, Brown J. Surgery for women with apical vaginal prolapse. Cochrane Database Syst Rev. 2016;10:Cd012376.
  • 8. Clark AL, Gregory T, Smith VJ, Edwards R. Epidemiologic evaluation of reoperation for surgically treated pelvic organ prolapse and urinary incontinence. American journal of obstetrics and gynecology. 2003;189(5):1261-7.
  • 9. Jelovsek JE, Barber MD, Brubaker L, Norton P, Gantz M, Richter HE, et al. Effect of Uterosacral Ligament Suspension vs Sacrospinous Ligament Fixation With or Without Perioperative Behavioral Therapy for Pelvic Organ Vaginal Prolapse on Surgical Outcomes and Prolapse Symptoms at 5 Years in the OPTIMAL Randomized Clinical Trial. Jama. 2018;319(15):1554-65.
  • 10. Barber MD, Brubaker L, Burgio KL, Richter HE, Nygaard I, Weidner AC, et al. Comparison of 2 transvaginal surgical approaches and perioperative behavioral therapy for apical vaginal prolapse: the OPTIMAL randomized trial. Jama. 2014;311(10):1023-34.
  • 11. Maher CF, Qatawneh AM, Dwyer PL, Carey MP, Cornish A, Schluter PJ. Abdominal sacral colpopexy or vaginal sacrospinous colpopexy for vaginal vault prolapse: a prospective randomized study. American journal of obstetrics and gynecology. 2004;190(1):20-6.
  • 12. Lantzsch T, Goepel C, Wolters M, Koelbl H, Methfessel HD. Sacrospinous ligament fixation for vaginal vault prolapse. Archives of gynecology and obstetrics. 2001;265(1):21-5.
  • 13. Morgan DM, Rogers MA, Huebner M, Wei JT, DeLancey JO. Heterogeneity in anatomic outcome of sacrospinous ligament fixation for prolapse: a systematic review. Obstetrics & Gynecology. 2007;109(6):1424-33.
  • 14. Sze EH, Karram MM. Transvaginal repair of vault prolapse: a review. Obstetrics & Gynecology. 1997;89(3):466-75.
  • 15. Meschia M, Bruschi F, Amicarelli F, Pifarotti P, Marchini M, Crosignani PG. The sacrospinous vaginal vault suspension: Critical analysis of outcomes. International urogynecology journal and pelvic floor dysfunction. 1999;10(3):155-9.
  • 16. Karram M, Goldwasser S, Kleeman S, Steele A, Vassallo B, Walsh P. High uterosacral vaginal vault suspension with fascial reconstruction for vaginal repair of enterocele and vaginal vault prolapse. American journal of obstetrics and gynecology. 2001;185(6):1339-43.
  • 17. Margulies RU, Lewicky-Gaupp C, Fenner DE, McGuire EJ, Clemens JQ, DeLancey JO. Complications requiring reoperation following vaginal mesh kit procedures for prolapse. American journal of obstetrics and gynecology. 2008;199(6):678. e1-. e4.
  • 18. Barber MD, Visco AG, Weidner AC, Amundsen CL, Bump RC. Bilateral uterosacral ligament vaginal vault suspension with site-specific endopelvic fascia defect repair for treatment of pelvic organ prolapse. American journal of obstetrics and gynecology. 2000;183(6):1402-10; discussion 10-1.

Comparing the Long-Term Outcome of Uterosacral and Sacrospinous Ligament Suspension Surgeries in Apical Pelvic Organ Prolapse

Year 2018, Volume: 10 Issue: 3, 381 - 386, 23.10.2018
https://doi.org/10.18521/ktd.462769

Abstract

Objective: We aimed to compare the long-term outcomes of the sacrospinous ligament suspension (SSLS) and uterosacral ligament suspension (ULS) procedures used for the treatment of apical pelvic organ prolapse (POP).

Methods: Fifty-two patients, diagnosed with apical POP, were included in this retrospective study. Twenty of these patients underwent The ULS procedure Fifty-two patients, diagnosed with apical POP, were included in this retrospective study. Twenty of these patients underwent The ULS procedure (Group 1), thirty-two patients (Group 2) were treated with bilateral SSLS. Operation type and time, objective and subjective cure rates, patient satisfaction rates and complications were obtained from hospital records at the operation time and 12-mounts, 36-mounts.

Results: The objective cure rates were 80% of group 1, 78.1% of group 2 at 12-month follow-up and %70 of group 1, 71.8% of group 2 at 36-month follow-up; the subjective cure rates were defined as 100% of group 1, 87.4% of group 2 at 12-month follow-up and %100 of group 1, 84.3% of group 2 at 36-month follow-up (p>0.05). Very satisfied patients were significantly higher in the ULS group compared to the SSLS group (p=0.048) but when compared totally satisfied (very satisfied and greatly improved) and dissatisfied patients, there was no significant difference between groups (p>0.05).

Conclusions: It was found that ULS and SSLS were not superior to each other according to success rates and patient’s satisfaction in the comparison of two commonly used methods apical prolapse by vaginal approach.

References

  • 1. Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub‐committee of the International Continence Society. Neurourology and urodynamics. 2002;21(2):167-78.
  • 2. Lowder JL, Ghetti C, Nikolajski C, Oliphant SS, Zyczynski HM. Body image perceptions in women with pelvic organ prolapse: a qualitative study. American journal of obstetrics and gynecology. 2011;204(5):441.e1-5.
  • 3. Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL. Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstetrics and gynecology. 1997;89(4):501-6.
  • 4. Smith FJ, Holman CD, Moorin RE, Tsokos N. Lifetime risk of undergoing surgery for pelvic organ prolapse. Obstetrics and gynecology. 2010;116(5):1096-100.
  • 5. Barber MD, Maher C. Epidemiology and outcome assessment of pelvic organ prolapse. International urogynecology journal. 2013;24(11):1783-90.
  • 6. Alas AN, Anger JT. Management of apical pelvic organ prolapse. Current urology reports. 2015;16(5):33.
  • 7. Maher C, Feiner B, Baessler K, Christmann-Schmid C, Haya N, Brown J. Surgery for women with apical vaginal prolapse. Cochrane Database Syst Rev. 2016;10:Cd012376.
  • 8. Clark AL, Gregory T, Smith VJ, Edwards R. Epidemiologic evaluation of reoperation for surgically treated pelvic organ prolapse and urinary incontinence. American journal of obstetrics and gynecology. 2003;189(5):1261-7.
  • 9. Jelovsek JE, Barber MD, Brubaker L, Norton P, Gantz M, Richter HE, et al. Effect of Uterosacral Ligament Suspension vs Sacrospinous Ligament Fixation With or Without Perioperative Behavioral Therapy for Pelvic Organ Vaginal Prolapse on Surgical Outcomes and Prolapse Symptoms at 5 Years in the OPTIMAL Randomized Clinical Trial. Jama. 2018;319(15):1554-65.
  • 10. Barber MD, Brubaker L, Burgio KL, Richter HE, Nygaard I, Weidner AC, et al. Comparison of 2 transvaginal surgical approaches and perioperative behavioral therapy for apical vaginal prolapse: the OPTIMAL randomized trial. Jama. 2014;311(10):1023-34.
  • 11. Maher CF, Qatawneh AM, Dwyer PL, Carey MP, Cornish A, Schluter PJ. Abdominal sacral colpopexy or vaginal sacrospinous colpopexy for vaginal vault prolapse: a prospective randomized study. American journal of obstetrics and gynecology. 2004;190(1):20-6.
  • 12. Lantzsch T, Goepel C, Wolters M, Koelbl H, Methfessel HD. Sacrospinous ligament fixation for vaginal vault prolapse. Archives of gynecology and obstetrics. 2001;265(1):21-5.
  • 13. Morgan DM, Rogers MA, Huebner M, Wei JT, DeLancey JO. Heterogeneity in anatomic outcome of sacrospinous ligament fixation for prolapse: a systematic review. Obstetrics & Gynecology. 2007;109(6):1424-33.
  • 14. Sze EH, Karram MM. Transvaginal repair of vault prolapse: a review. Obstetrics & Gynecology. 1997;89(3):466-75.
  • 15. Meschia M, Bruschi F, Amicarelli F, Pifarotti P, Marchini M, Crosignani PG. The sacrospinous vaginal vault suspension: Critical analysis of outcomes. International urogynecology journal and pelvic floor dysfunction. 1999;10(3):155-9.
  • 16. Karram M, Goldwasser S, Kleeman S, Steele A, Vassallo B, Walsh P. High uterosacral vaginal vault suspension with fascial reconstruction for vaginal repair of enterocele and vaginal vault prolapse. American journal of obstetrics and gynecology. 2001;185(6):1339-43.
  • 17. Margulies RU, Lewicky-Gaupp C, Fenner DE, McGuire EJ, Clemens JQ, DeLancey JO. Complications requiring reoperation following vaginal mesh kit procedures for prolapse. American journal of obstetrics and gynecology. 2008;199(6):678. e1-. e4.
  • 18. Barber MD, Visco AG, Weidner AC, Amundsen CL, Bump RC. Bilateral uterosacral ligament vaginal vault suspension with site-specific endopelvic fascia defect repair for treatment of pelvic organ prolapse. American journal of obstetrics and gynecology. 2000;183(6):1402-10; discussion 10-1.
There are 18 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Articles
Authors

Gokmen Sukgen 0000-0002-1597-2799

Askı Ellibes Kaya 0000-0002-1323-7416

Publication Date October 23, 2018
Acceptance Date October 1, 2018
Published in Issue Year 2018 Volume: 10 Issue: 3

Cite

APA Sukgen, G., & Ellibes Kaya, A. (2018). Comparing the Long-Term Outcome of Uterosacral and Sacrospinous Ligament Suspension Surgeries in Apical Pelvic Organ Prolapse. Konuralp Medical Journal, 10(3), 381-386. https://doi.org/10.18521/ktd.462769
AMA Sukgen G, Ellibes Kaya A. Comparing the Long-Term Outcome of Uterosacral and Sacrospinous Ligament Suspension Surgeries in Apical Pelvic Organ Prolapse. Konuralp Medical Journal. October 2018;10(3):381-386. doi:10.18521/ktd.462769
Chicago Sukgen, Gokmen, and Askı Ellibes Kaya. “Comparing the Long-Term Outcome of Uterosacral and Sacrospinous Ligament Suspension Surgeries in Apical Pelvic Organ Prolapse”. Konuralp Medical Journal 10, no. 3 (October 2018): 381-86. https://doi.org/10.18521/ktd.462769.
EndNote Sukgen G, Ellibes Kaya A (October 1, 2018) Comparing the Long-Term Outcome of Uterosacral and Sacrospinous Ligament Suspension Surgeries in Apical Pelvic Organ Prolapse. Konuralp Medical Journal 10 3 381–386.
IEEE G. Sukgen and A. Ellibes Kaya, “Comparing the Long-Term Outcome of Uterosacral and Sacrospinous Ligament Suspension Surgeries in Apical Pelvic Organ Prolapse”, Konuralp Medical Journal, vol. 10, no. 3, pp. 381–386, 2018, doi: 10.18521/ktd.462769.
ISNAD Sukgen, Gokmen - Ellibes Kaya, Askı. “Comparing the Long-Term Outcome of Uterosacral and Sacrospinous Ligament Suspension Surgeries in Apical Pelvic Organ Prolapse”. Konuralp Medical Journal 10/3 (October 2018), 381-386. https://doi.org/10.18521/ktd.462769.
JAMA Sukgen G, Ellibes Kaya A. Comparing the Long-Term Outcome of Uterosacral and Sacrospinous Ligament Suspension Surgeries in Apical Pelvic Organ Prolapse. Konuralp Medical Journal. 2018;10:381–386.
MLA Sukgen, Gokmen and Askı Ellibes Kaya. “Comparing the Long-Term Outcome of Uterosacral and Sacrospinous Ligament Suspension Surgeries in Apical Pelvic Organ Prolapse”. Konuralp Medical Journal, vol. 10, no. 3, 2018, pp. 381-6, doi:10.18521/ktd.462769.
Vancouver Sukgen G, Ellibes Kaya A. Comparing the Long-Term Outcome of Uterosacral and Sacrospinous Ligament Suspension Surgeries in Apical Pelvic Organ Prolapse. Konuralp Medical Journal. 2018;10(3):381-6.