title: Long-Term Effectiveness of Uterosacral Colpopexy and Minimally Invasive Sacral Colpopexy for Treatment of Pelvic Organ Prolapse.
abstract: The objective of this study was to estimate rates of recurrent pelvic organ prolapse (POP) 6 years after patients underwent transvaginal uterosacral colpopexy, or laparoscopic or robotic sacral colpopexy at a large tertiary care center. We hypothesized that recurrence rates would be higher than those previously reported.
  
  
  
  This is a retrospective study of women who underwent uterosacral colpopexy, laparoscopic, and robotic sacral colpopexy for treatment of POP between 2006 and 2012. A composite outcome for recurrent POP was defined as subjective failure (vaginal bulge symptoms), objective failure (prolapse to or beyond the hymen), or any retreatment for POP (reoperation or use of a pessary). Kaplan-Meier survival curves were generated from each patient's date of follow-up, and parametric survival modeling was used to estimate recurrent POP over 6 years. Annual estimated recurrence rates by type of colpopexy are reported using the composite and individual definitions for recurrent POP.
  
  
  
  One thousand three hundred eighty-one subjects met inclusion criteria: 983 (71.1 %) uterosacral, 256 (18.5%) laparoscopic, and 142 (11.2%) robotic colpopexies. Median (range) months to failure using composite recurrence were as follows: uterosacral, 17.1 (7.6-41); laparoscopic, 10.1 (4.7-25.1); robotic, 9.7 (1.6-17.2). By year 6 in the model, the estimated composite recurrence rates for the uterosacral colpopexy, robotic, and laparoscopic sacral colpopexy groups were 43%, 49%, and 57%, respectively.
  
  
  
  Estimated recurrence rates for uterosacral ligament colpopexy, laparoscopic, and robotic sacral colpopexy may be as high as 40% to 60% 6 years after surgery.
authors.affiliation: From the Cleveland Clinic, Obstetrics, Gynecology & Women's Health Institute, Center for Urogynecology and Pelvic Reconstructive Surgery, Cleveland, OH.
authors.forename: Cecile A
authors.initials: CA
authors.lastname: Unger
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Barber
authors.forename: Mark D
authors.initials: MD
authors.lastname: Walters
authors.forename: Marie Fidela R
authors.initials: MFR
authors.lastname: Paraiso
authors.forename: Beri
authors.initials: B
authors.lastname: Ridgeway
authors.forename: J Eric
authors.initials: JE
authors.lastname: Jelovsek
mesh_terms: D000368:Aged; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000706:statistics & numerical data*; D006801:Humans; D053208:Kaplan-Meier Estimate; D010535:Laparoscopy / Q000009:adverse effects / Q000706:statistics & numerical data; D008137:Longitudinal Studies; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000706:statistics & numerical data; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D065287:Robotic Surgical Procedures / Q000009:adverse effects / Q000706:statistics & numerical data; D017211:Treatment Failure; D014621:Vagina / Q000601:surgery*