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Recurrent surgery in uterine prolapse: A nationwide register study
Malin Brunes1,2, Ulrika Johannesson3,4, Anna Drca1,2
1Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
Acta Obstetricia Et Gynecologica Scandinavica
|March 8, 2022
Summary
The Manchester procedure shows a lower rate of pelvic organ prolapse (POP) recurrence and complications compared to other surgical methods for uterine prolapse. This surgical approach offers better outcomes for women experiencing uterine prolapse.
Area of Science:
- Urogynecology
- Pelvic Floor Surgery
- Surgical Outcomes Research
Background:
- Pelvic organ prolapse (POP) affects many women, with a significant relapse rate after surgery.
- Uterine prolapse lacks an optimal surgical treatment, necessitating comparative studies.
Purpose of the Study:
- To compare the relapse rates of uterine prolapse surgeries.
- To evaluate surgical treatments for uterine prolapse, including hysterectomy with suspension and uterine-sparing procedures.
Main Methods:
- Population-based register study in Sweden (2015-2018).
- Identified women undergoing uterine prolapse surgery from the Gynecological Operation Register (GynOp).
- Primary outcome: recurrent POP surgery rates up to December 2020.
Main Results:
- Sacrospinous hysteropexy (SSHP) without graft and sacrohysteropexy (SHP) had higher recurrence rates and sense of globe compared to the Manchester procedure.
- SSHP without graft also showed increased 1-year postoperative complications versus the Manchester procedure and SHP.
- SSHP with graft had higher 1-year postoperative complications than the Manchester procedure.
Conclusions:
- The Manchester procedure demonstrated a low rate of recurrent POP surgery and symptomatic recurrence.
- This method was associated with low surgical morbidity in women with uterine prolapse.
- The Manchester procedure appears superior to other evaluated methods for uterine prolapse repair.
