E-Posters-Effectiveness of Vaginal High Uterosacral Ligament Suspension for Treatment of Recurrent Pelvic Organ Prolapse

Effectiveness of Vaginal High Uterosacral Ligament Suspension for Treatment of Recurrent Pelvic Organ Prolapse - Yongxian Lu, MD

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The study evaluated the effectiveness of vaginal high uterosacral ligament (HUS) suspension for the treatment of recurrent pelvic organ prolapse (POP). The retrospective analysis included 42 women who underwent transvaginal HUS with vaginal wall repair between November 2005 and January 2018. The primary surgeries for these women included vaginal colporrhaphy, Manchester operation, trans-vaginal mesh repair, and sacrospinous ligament fixation. The median time for recurrence from the primary pelvic floor repair surgery was 9 months. The indications for recurrent pelvic floor repair were severe symptoms affecting quality of life, rejection of pessary and desire for reoperation, and POP-Q > stage III. The indications for transvaginal HUS were a demand for sexual function, lack of apical support, and sufficient vaginal length and volume. <br /><br />The results showed that transvaginal HUS with vaginal wall repair can be a safe, cost-effective, minimal traumatic, and durable procedure for recurrent POP in most cases. The transvaginal HUS procedure involved bilateral uterosacral ligament suspension after vaginal hysterectomy and residual cervical resection. Transvaginal mesh was used in some cases for the anterior and posterior walls. There were no major intra- or postoperative complications, and the mean follow-up time was 5.3 years. The points on the Pelvic Organ Prolapse Quantification (POP-Q) system significantly reduced after reoperation, and the subjective cure rate was 95.2%. The objective cure rate was 100% in the apex and posterior compartment, and 92% in the anterior compartment. None of the patients required reoperation or pessary usage for the recurrence of prolapse.<br /><br />In conclusion, transvaginal HUS with vaginal wall repair can be an effective treatment option for recurrent advanced POP. The procedure has good clinical outcomes with minimal complications and a high cure rate.

Keywords

vaginal high uterosacral ligament suspension

recurrent pelvic organ prolapse

retrospective analysis

transvaginal HUS

vaginal wall repair

primary surgeries

recurrence

pelvic floor repair surgery

transvaginal mesh

Pelvic Organ Prolapse Quantification (POP-Q)