title: Vaginal vault suspension during hysterectomy for benign indications: a prospective register study of agreement on terminology and surgical procedure.
abstract: OBJECTIVE
  Several suspension methods are used to try to prevent pelvic organ prolapse (POP) after hysterectomy. We aimed to evaluate agreement on terminology and surgical procedure of these methods.
  
  
  METHODS
  We randomly chose 532 medical records of women with a history of hysterectomy from the Danish Hysterectomy and Hysteroscopy Database (DHHD). Additionally, we video-recorded 36 randomly chosen hysterectomies. The hysterectomies were registered in the DHHD. The material was categorized according to predefined suspension methods. Agreement compared suspension codes in DHHD (gynecologists' registrations) with medical records (gynecologists' descriptions) and with videos (reviewers' categorizations) respectively. Whether the vaginal vault was suspended (pooled suspension) or not (no suspension method + not described) was analyzed, in addition to each suspension method.
  
  
  RESULTS
  Regarding medical records, agreement on terminology was good among patients undergoing pooled suspension in cases of hysterectomy via the abdominal and vaginal route (agreement 78.7, 92.3%). Regarding videos, agreement on surgical procedure was good among pooled suspension patients in cases of hysterectomy via the abdominal, laparoscopic, and vaginal routes (agreement 88.9, 97.8, 100%). Agreement on individual suspension methods differed regarding both medical records (agreement 0-90.1%) and videos (agreement 0-100%).
  
  
  CONCLUSIONS
  Agreement on terminology and surgical procedure regarding suspension method was good in respect of pooled suspension. However, disagreement was observed when individual suspension methods and operative details were scrutinized. Better consensus of terminology and surgical procedure is warranted to enable further research aimed at preventing POP among women undergoing hysterectomy.
authors.affiliation: Department of Obstetrics and Gynecology, Nykoebing Falster Hospital, Nykoebing Falster, Denmark. lisbeth.bonde@dadlnet.dk.|University of Southern Denmark, Odense, Denmark. lisbeth.bonde@dadlnet.dk.|Department of Gynecology, Juliane Marie Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. lisbeth.bonde@dadlnet.dk.
authors.forename: Lisbeth
authors.identifier: http://orcid.org/0000-0003-0822-6752
authors.initials: L
authors.lastname: Bonde
authors.affiliation: Department of Gynecology, Juliane Marie Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
authors.forename: Mette Calundann
authors.initials: MC
authors.lastname: Noer
authors.affiliation: Department of Obstetrics and Gynecology, Zealand University Hospital, Zealand, Denmark.
authors.forename: Lars Alling
authors.initials: LA
authors.lastname: Møller
authors.affiliation: Department of Gynecology, Juliane Marie Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
authors.forename: Bent
authors.initials: B
authors.lastname: Ottesen
authors.affiliation: Department of Obstetrics and Gynecology, Nykoebing Falster Hospital, Nykoebing Falster, Denmark.|University of Southern Denmark, Odense, Denmark.
authors.forename: Helga
authors.initials: H
authors.lastname: Gimbel
mesh_terms: D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D011446:Prospective Studies; D012189:Retrospective Studies; D009626:Terminology as Topic
keywords: Medical records; Pelvic organ prolapse; Surgery; Suspension; Vaginal vault; Video