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Long-Term Comparison of Patient-Reported Outcomes Following Six Surgical Procedures for Apical Suspension
Dorte Teilmann-Jørgensen1,2, Niels Klarskov3,4, Ditte Gommesen5
1Department of Obstetrics and Gynaecology, Odense University Hospital, Kløvervænget 23, 5000, Odense C, Denmark. dorte.teilmann-jorgensen@rsyd.dk.
Sacrocolpopexy (SCP) demonstrated the lowest long-term symptom burden for vaginal vault suspension (VVS). Other procedures like sacrospinous ligament fixation with graft (SSLF with graft) and ipsilateral uterosacral ligament suspension (IUSLS) showed higher symptom burden in specific areas.
Area of Science:
- Urogynecology
- Pelvic Floor Surgery
- Patient-Reported Outcomes
Background:
- Apical prolapse significantly impacts women's quality of life.
- Vaginal vault suspension (VVS) is a common surgical approach for apical prolapse.
- Long-term comparative outcomes of different VVS procedures are not well-established.
Purpose of the Study:
- To compare long-term patient-reported outcomes across six distinct surgical procedures for first-time vaginal vault suspension (VVS).
- To identify which VVS procedures offer the best long-term symptom relief for apical prolapse.
Main Methods:
- Nationwide cohort study with 3-14 years of follow-up.
- Included 1016 women undergoing first-time VVS for apical prolapse.
- Utilized national databases and validated questionnaires (ICIQ-VS, PFDI-20, PFIQ-7) to assess outcomes.
Main Results:
- Sacrocolpopexy (SCP) was associated with the lowest global impact of vaginal symptoms.
- Ipsilateral uterosacral ligament suspension (IUSLS) and sacrospinous ligament fixation (SSLF) showed higher symptom burden compared to SCP.
- Sacrospinous ligament fixation with graft (SSLF with graft) and IUSLS were linked to increased sexual symptom burden and overall pelvic floor impact.
Conclusions:
- Sacrocolpopexy (SCP) appears to offer superior long-term symptom control for apical prolapse compared to other VVS procedures.
- Sacrospinous ligament fixation with graft (SSLF with graft) and ipsilateral uterosacral ligament suspension (IUSLS) may lead to higher symptom burden in specific domains.
- Findings suggest procedural choice may influence long-term patient-reported outcomes, though potential confounding factors warrant cautious interpretation.