Sacrospinous hysteropexy compared to vaginal hysterectomy as primary surgical treatment for a descensus uteri: effects on urinary symptoms.
One hundred and three women underwent sacrospinous hysteropexy (n=54) or vaginal hysterectomy with a vaginal vault suspension (n=49) for the management of descensus uteri. They were sent a postal questionnaire. Logistic regression analysis was used to obtain crude and adjusted odds ratios. Seventy-four (72%) women responded. The adjusted odds ratios for urge incontinence is 3.4 (1.0-12.3) and for overactive bladder 2.9 (0.5-16.9) greater after vaginal hysterectomy. The women recovered significantly more quickly after sacrospinous hysteropexy. There were no differences in anatomical outcome or recurrence rate. When performed to correct a descensus uteri of grade 2 or more we found that vaginal hysterectomy is associated with a three times higher risk for urge incontinence and overactive bladder symptoms. In addition, the women who underwent sacrospinous hysteropexy also reported a quicker recovery from surgery. Sacrospinous hysteropexy, therefore, appears to be promising for the correction of descensus uteri.
van Brummen
H J
HJ
Department of Obstetrics and Gynecology, University Medical Center Utrecht, Room F 05.829, Heidelberglaan 100, 3508 GA Utrecht, The Netherlands. h.j.vanbrummen@azu.nl
van de Pol
G
G
Aalders
C I M
CI
Heintz
A P M
AP
van der Vaart
C H
CH
D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007045:Hysterectomy, Vaginal; D008875:Middle Aged; D014550:Urinary Incontinence, Stress / Q000209:etiology; D014555:Urination Disorders / Q000209:etiology*; D014596:Uterine Prolapse / Q000601:surgery*; D014599:Uterus / Q000601:surgery*; D014621:Vagina / Q000601:surgery