PFD Week 2018-General Session I

Video Transcription

Video Summary

Dr. Charles Nager presented the results of a study comparing vaginal surgery options for uterovaginal prolapse. The study compared vaginal hysterectomy with uterosacral ligament suspension to vaginal mesh hysterepexy. The primary aim of the study was to determine if treatment success differed between the two procedures at different time points over a minimum of three years. The study included 183 women who were randomized to receive either vaginal hysterectomy or vaginal mesh hysterepexy. The primary outcome measure was treatment failure, which included retreatment, pop-Q measure beyond the hymen, or symptoms of bulge. Secondary outcomes included anatomic, functional, safety, and adverse event measures. The study found that there was no statistically significant difference in treatment success between the two procedures at 36 months. However, the mesh hysterepexy group had a higher success rate, 73.8%, compared to the hysterectomy group, 62.5%. There were also differences in anatomical outcomes, with the mesh hysterepexy group showing slightly better anterior wall and total vaginal length measurements. Complication rates were minimal, with more suture exposure and granulation tissue in the hysterectomy group. Both groups reported improvements in patient-reported outcomes, sexual function, and low rates of pelvic pain and dyspareunia. The conclusion of the study is that both vaginal hysterectomy with uterocyclic ligament suspension and mesh hysterepexy are effective treatments for uterovaginal prolapse, with comparable outcomes at 36 months.

Asset Subtitle

Charles W. Nager, MD, Katrina M Knight, PhD, Taylor John Brueseke, MD, Colby J Schrum, DO, Vivian W. Sung, MD, MPH, & Lauren E Giugale, MD

Meta Tag

Category Pelvic Organ Prolapse

Category Education

Category Urinary Incontinence

Concept Vaginal Hysterectomy

Concept Uterosacral Ligament Suspension

Concept Vaginal Mesh Hysteropexy

Concept Randomized Trial

Concept Staged Midurethral Sling

Concept Sling Procedure

Keywords

Dr. Charles Nager

vaginal surgery options

uterovaginal prolapse

vaginal hysterectomy

mesh hysterepexy group

complication rates

patient-reported outcomes

Pelvic Organ Prolapse

Education

Urinary Incontinence

Vaginal Hysterectomy

Uterosacral Ligament Suspension

Vaginal Mesh Hysteropexy

Randomized Trial

Staged Midurethral Sling

Sling Procedure