Laparoscopic uterosacral ligament uterine suspension compared with vaginal hysterectomy with vaginal vault suspension for uterovaginal prolapse.
This study compares the outcomes of laparoscopic uterosacral ligament uterine suspension (LUSUS) to those of vaginal vault suspension with total vaginal hysterectomy (TVH) for the treatment of symptomatic uterovaginal prolapse. We compared the outcomes of 25 LUSUS to those of 25 TVH with vaginal vault suspension among age-matched controls. No significant complications occurred in either group. EBL and hospitalization duration were significantly less in LUSUS patients (72 cc vs. 227 cc, P < .0001 and 1.05 vs. 1.65 days, P = .002). Vault support, as measured by postoperative pelvic organ prolapse quantitation system point D in the LUSUS group and point C in the TVH group, was better for the LUSUS group (D = -9 vs. C = -7.6, P = .002). No LUSUS group patient underwent reoperation for recurrent apical prolapse as compared to three TVH patients. LUSUS is an effective treatment for appropriately selected women with uterovaginal prolapse who desire uterine preservation.
Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA. aparnadiwan@yahoo.com
Aparna
A
Diwan
Charles R
CR
Rardin
William C
WC
Strohsnitter
Alexandra
A
Weld
Peter
P
Rosenblatt
Neeraj
N
Kohli
D000328:Adult; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D007045:Hysterectomy, Vaginal; D010535:Laparoscopy; D008022:Ligaments / Q000601:surgery; D016896:Treatment Outcome; D014596:Uterine Prolapse / Q000601:surgery*