AUGS/IUGA Scientific Meeting 2019-Best Abstract Presentations / Late breaking Abstracts - Best Clinical/Surgical Abstract & Best Basic Science Abstract

Best Abstract Presentations / Late breaking Abstracts - Best Clinical/Surgical Abstract & Best Basic Science Abstract

Video Transcription

Video Summary

In a five-year follow-up of the SAVE-U trial, which compared sacrospinous hysterectomy to vaginal hysterectomy with utero-sacral ligament suspension, researchers found that sacrospinous hysterectomy was more effective and had a lower risk of retreatment for recurrent prolapse. The study included 208 women with uterine stage two prolapse or higher, who were randomly assigned to either sacrospinous hysterectomy or vaginal hysterectomy with utero-sacral ligament suspension. The primary outcome measure was surgical failure, defined as recurrent prolapse combined with bothersome bulge symptoms or repeat surgery. After 12 months, sacrospinous hystereopoxy was found to be non-inferior to vaginal hysterectomy for surgical failure. In the five-year follow-up, surgical failure of the apical compartment occurred significantly less frequently after sacrospinous hysterectomy, with only one woman experiencing it compared to eight women in the vaginal hysterectomy group. Overall anatomical failure did not significantly differ between groups. However, a composite outcome of success was found significantly more often after sacrospinous hystereopoxy. Repeat surgery for recurrent prolapse was also less frequent after sacrospinous hystereopoxy. Functional outcome, quality of life, and sexual functioning did not differ significantly between the two procedures. The study concludes that sacrospinous hystereopoxy is an effective and safe option in the surgical treatment of uterine prolapse and offers women the opportunity to choose uterus preservation and avoid hysterectomy. Further studies comparing other uterus-preserving procedures are needed.

Asset Caption

Sascha FM Schulten, Kathleen A. Connell, MD, Olivia H. Chang, MD, MPH

Keywords

SAVE-U trial

sacrospinous hysterectomy

vaginal hysterectomy

utero-sacral ligament suspension

recurrent prolapse

surgical failure

repeat surgery