E-Posters-10164

10164_Vaughan

Pdf Summary

A study conducted by the Department of Obstetrics & Gynecology at Duke University Health System examined the impact of genital hiatus size on anatomic failure after native tissue vaginal vault suspension. The study included 263 women who underwent this procedure and were followed up for medium-term outcomes. The researchers found that a persistently wide genital hiatus (GH) after surgery was associated with a significantly higher risk of anatomic failure compared to women with improved or stably normal GH.<br /><br />The primary outcome measure for the study was anatomic failure, defined as recurrent prolapse beyond the hymen or retreatment for prolapse with surgery or a pessary. The researchers used continuous and categorical variables analysis and multivariable logistic regression to evaluate the risk factors for anatomic failure among the different GH groups.<br /><br />The results showed that recurrence after native tissue prolapse repair is estimated to be as high as 30%, with risks varying by procedure. A widened GH was associated with apical support loss, anterior wall recurrence, and recurrent overall prolapse. Mathematical models have suggested that a GH size of 3.75 cm is a good predictor of vaginal apical support loss.<br /><br />In terms of GH group distribution, 14.8% of women had persistently wide GH, 60.5% had improved GH, and 24.7% had stably normal GH. Anatomic failure was significantly more likely in the persistently wide GH group compared to the other groups. Logistic regression analysis, when controlling for other covariates, showed that the persistently wide GH group had a 4.6-fold increased odds of composite failure compared to the improved GH group and a 16.1-fold increased odds compared to the normal GH group.<br /><br />The study concludes that reducing genital hiatus size can decrease the risk of anatomic failure after native tissue vaginal vault suspension. These findings emphasize the importance of considering genital anatomy and optimizing surgical techniques to achieve successful outcomes in women undergoing pelvic organ prolapse surgery.

Keywords

genital hiatus size

anatomic failure

native tissue vaginal vault suspension

medium-term outcomes

recurrent prolapse

risk factors

apical support loss

anterior wall recurrence

persistently wide GH

pelvic organ prolapse surgery