title: Medium-term outcomes after combined trachelectomy and uterosacral ligament suspension among young women with severe uterine prolapse.
abstract: OBJECTIVE
  To evaluate anatomic and sexual outcomes among young women with severe pelvic organ prolapse undergoing combined trachelectomy and laparoscopic high uterosacral ligament suspension (LHUS).
  
  
  METHODS
  In a prospective study in Beijing, China, patients (aged ≤50 years) with pelvic organ prolapse of stage III or higher according to the Pelvic Organ Prolapse Quantification (POP-Q) were enrolled between November 2007 and August 2011. After combined trachelectomy and LHUS, patients were followed up at 6 weeks, 6 months, 12 months, and yearly thereafter. Anatomic success was defined as POP-Q lower than stage II. Sexual outcomes were assessed at 6 months via the validated Short-Form Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12), and compared with a control group of 39 healthy age-matched women.
  
  
  RESULTS
  Among 49 patients, surgical success and patient satisfaction rates were 100% after a median follow-up of 54 months. Among 48 patients who were sexually active at follow-up, 39 (81%) completed the PISQ-12 questionnaire. The 6-month PISQ-12 score was higher than the preoperative score overall (38.1 vs 26.4, P<0.001) and for all three subscale domains (P≤0.001). The PISQ-12 score of postoperative patients was similar to that of control women (36.8, P=0.52).
  
  
  CONCLUSIONS
  Trachelectomy combined with LHUS produced satisfactory medium-term anatomic and functional outcomes for young women with severe uterine prolapse.
authors.affiliation: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China; Department of Pediatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China.
authors.forename: Zhixing
authors.initials: Z
authors.lastname: Sun
authors.affiliation: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China. Electronic address: zhu_julie@sina.com.
authors.forename: Lan
authors.initials: L
authors.lastname: Zhu
authors.affiliation: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China.
authors.forename: Huiying
authors.initials: H
authors.lastname: Hu
authors.affiliation: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China.
authors.forename: Jinghe
authors.initials: J
authors.lastname: Lang
authors.affiliation: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China.
authors.forename: Honghui
authors.initials: H
authors.lastname: Shi
authors.affiliation: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China.
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Gong
mesh_terms: D000328:Adult; D000068476:Beijing; D016022:Case-Control Studies; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000379:methods / Q000523:psychology*; D006801:Humans; D010535:Laparoscopy / Q000379:methods / Q000523:psychology*; D008022:Ligaments / Q000601:surgery; D008875:Middle Aged; D017060:Patient Satisfaction; D011184:Postoperative Period; D011446:Prospective Studies; D012445:Sacrococcygeal Region / Q000601:surgery; D012720:Severity of Illness Index; D012725:Sexual Behavior / Q000523:psychology*; D011795:Surveys and Questionnaires; D000069339:Trachelectomy / Q000523:psychology*; D016896:Treatment Outcome; D014596:Uterine Prolapse / Q000523:psychology* / Q000601:surgery; D014599:Uterus / Q000601:surgery
keywords: Clinical outcome; High uterosacral ligament suspension; Laparoscopy; Severe; Uterine prolapse