Hysteropexy compared to hysterectomy for uterine prolapse surgery: does durability differ?
OBJECTIVE
The aim of this study is to assess the impact of hysterectomy on durability of uterine prolapse repair by comparing hysterectomy/uterosacral cuff suspension (VH) to a new vaginal uterosacral hysteropexy (USH).


METHODS
A retrospective chart review of uterine prolapse patients after USH or VH with concomitant procedures as indicated was conducted, analyzing Baden-Walker grading of apex, anterior, and posterior compartments (Kaplan-Meier analysis) Baden et al. (Tex Med 64(5):56-58, 1968).


RESULTS
A total of 200 charts met criteria. USH women weighed less, were younger, and more constipated with larger rectoceles. Levator parameters did not differ Romanzi et al. (Neurourol Urodyn 18(6):603-612, 1999). Baden-Walker data were entered at recurrence or minimum of 6 months (2.4 months-10 years; median, 1.5 years). All-apex durability was 96.4%, with no difference between hysteropexy and cuff suspension (96.0% vs. 96.8%, p = 0.90), cystocele (86.8% vs. 93.8%, p = 0.31), or rectocele (97.8% vs. 100%, p = 0.16) at 2 years.


CONCLUSIONS
In uterine prolapse patients, technically similar uterosacral hysteropexy durability did not differ from hysterectomy-based cuff suspension nor between cohorts for cystocele or rectocele.
Obstetrics and Gynecology, New York Presbyterian Hospital, Weill Cornell Medical College, 133 East 58th Street, New York, NY 10022, USA. ljromanzi@gmail.com
Lauri J
LJ
Romanzi
Renuka
R
Tyagi
D000328:Adult; D000368:Aged; D001696:Biomechanical Phenomena; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008875:Middle Aged; D012189:Retrospective Studies; D013526:Surgical Mesh; D016896:Treatment Outcome; D014596:Uterine Prolapse / Q000601:surgery*