Surgical Outcomes After Apical Repair for Vault Compared With Uterovaginal Prolapse
OBJECTIVE:To retrospectively compare surgical success and complications between vaginal vault prolapse compared with uterovaginal prolapse in women who underwent apical prolapse repair for stage II–IV prolapse. METHODS:Women in one of three Pelvic Floor Disorders Network prolapse surgical trials wer...
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| Veröffentlicht in: | Obstetrics and gynecology (New York. 1953) 2018-03, Vol.131 (3), p.475-483 |
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| creator | Rogers, Rebecca G. Nolen, Tracy L. Weidner, Alison C. Richter, Holly E. Jelovsek, J. Eric Shepherd, Jonathan P. Harvie, Heidi S. Brubaker, Linda Menefee, Shawn A. Myers, Deborah Hsu, Yvonne Schaffer, Joseph I. Wallace, Dennis Meikle, Susan F. |
| description | OBJECTIVE:To retrospectively compare surgical success and complications between vaginal vault prolapse compared with uterovaginal prolapse in women who underwent apical prolapse repair for stage II–IV prolapse.
METHODS:Women in one of three Pelvic Floor Disorders Network prolapse surgical trials were included. Absence of bothersome bulge symptoms, no prolapse beyond the hymen, and no subsequent prolapse treatment defined success and was our primary outcome. Secondary outcomes included comparison of quality-of-life measures, anatomic changes, and adverse events. Pelvic organ prolapse quantification (POP-Q) and quality-of-life measures were administered at baseline and 1–2 years postoperatively. Comparisons were controlled for study site, age, body mass index, baseline POP-Q, apical and anterior or posterior repair performed, and prior prolapse repair. Outcomes measured at multiple time points were analyzed using longitudinal models to assess whether differences existed across study follow-up.
RESULTS:Four hundred twenty-one women underwent vault prolapse, and 601 underwent uterovaginal prolapse apical repair. The vault prolapse group was older, more likely to be white, and to have prior urinary incontinence or prolapse repair, stage IV prolapse, and more prolapse bother on a validated scale (all P≤.034). The vault prolapse group was more likely to undergo sacrocolpopexy (228/421 [54%] vs 93/601 [15%]); the uterovaginal prolapse group was more likely to undergo vaginal repair (508/601 [85%] vs 193/421 [46%] P |
| doi_str_mv | 10.1097/AOG.0000000000002492 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5823764</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2001067999</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5022-cb7ba50bdc8a0ed54a6bf6ebfc2ea490de74adc35ec8ffe922595b5ea0b4326c3</originalsourceid><addsrcrecordid>eNqFkU1P3DAQhq2Kqiwf_wChHLmEOv5I4gvSagXbSkhbFWi5WRNnshtw1sFOQP33eLsUQQ-tL5bHz_vOaF5CjjJ6mlFVfJ4u5qf0zWFCsQ9kkpUFTxnntztkEosqLUohdsleCHcRynLFP5FdpgSjgqoJuboa_bI1YJPFOBjXYUimzYA-mfa_q9-xh9YnjfPJDxjtkMxc14PHOvnZDqvkJqLuEZbtOrLfvLPQBzwgHxuwAQ9f7n1yc3F-PfuSXi7mX2fTy9RIylhqqqICSavalECxlgLyqsmxagxDEIrWWAioDZdoyqZBxZhUspIItBKc5Ybvk7Otbz9WHdYG14MHq3vfduB_aQetfv-zbld66R61LBkvchENTl4MvHsYMQy6a4NBa2GNbgyaxYXRvFBKRVRsUeNdCB6b1zYZ1Zs8dMxD_51HlB2_HfFV9CeACJRb4MnZuMtwb8cn9HqFYIfV_7zFP6QbLGeSpoxmJeXxlW7yp_wZ--KpRQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2001067999</pqid></control><display><type>article</type><title>Surgical Outcomes After Apical Repair for Vault Compared With Uterovaginal Prolapse</title><source>MEDLINE</source><source>Journals@Ovid Complete</source><creator>Rogers, Rebecca G. ; Nolen, Tracy L. ; Weidner, Alison C. ; Richter, Holly E. ; Jelovsek, J. Eric ; Shepherd, Jonathan P. ; Harvie, Heidi S. ; Brubaker, Linda ; Menefee, Shawn A. ; Myers, Deborah ; Hsu, Yvonne ; Schaffer, Joseph I. ; Wallace, Dennis ; Meikle, Susan F.</creator><creatorcontrib>Rogers, Rebecca G. ; Nolen, Tracy L. ; Weidner, Alison C. ; Richter, Holly E. ; Jelovsek, J. Eric ; Shepherd, Jonathan P. ; Harvie, Heidi S. ; Brubaker, Linda ; Menefee, Shawn A. ; Myers, Deborah ; Hsu, Yvonne ; Schaffer, Joseph I. ; Wallace, Dennis ; Meikle, Susan F. ; Eunice Kennedy Shriver National Institute of Child Health and Human Development Pelvic Floor Disorders Network ; for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Pelvic Floor Disorders Network</creatorcontrib><description>OBJECTIVE:To retrospectively compare surgical success and complications between vaginal vault prolapse compared with uterovaginal prolapse in women who underwent apical prolapse repair for stage II–IV prolapse.
METHODS:Women in one of three Pelvic Floor Disorders Network prolapse surgical trials were included. Absence of bothersome bulge symptoms, no prolapse beyond the hymen, and no subsequent prolapse treatment defined success and was our primary outcome. Secondary outcomes included comparison of quality-of-life measures, anatomic changes, and adverse events. Pelvic organ prolapse quantification (POP-Q) and quality-of-life measures were administered at baseline and 1–2 years postoperatively. Comparisons were controlled for study site, age, body mass index, baseline POP-Q, apical and anterior or posterior repair performed, and prior prolapse repair. Outcomes measured at multiple time points were analyzed using longitudinal models to assess whether differences existed across study follow-up.
RESULTS:Four hundred twenty-one women underwent vault prolapse, and 601 underwent uterovaginal prolapse apical repair. The vault prolapse group was older, more likely to be white, and to have prior urinary incontinence or prolapse repair, stage IV prolapse, and more prolapse bother on a validated scale (all P≤.034). The vault prolapse group was more likely to undergo sacrocolpopexy (228/421 [54%] vs 93/601 [15%]); the uterovaginal prolapse group was more likely to undergo vaginal repair (508/601 [85%] vs 193/421 [46%] P<.001). There were no differences in success (odds ratio [OR] 0.76 for vault prolapse vs uterovaginal prolapse, 95% CI 0.51–1.15, P=.20), changes in Pelvic Organ Prolapse Distress Inventory scores (−79.4 vs −79.8, P=.89), postoperative POP-Q point C measurements (−7.0 vs −7.1 cm, P=.41), or serious adverse events (86/421 [20%] vs 90/601 [15%], P=.86) between groups. Among women who underwent a vaginal approach for repair of vault prolapse (n=193) or uterovaginal prolapse (n=508), there were no differences in success rates (OR 0.67, 95% CI 0.43–1.04, P=.09) at 1–2 years postoperatively.
CONCLUSION:Surgical success of stage II–IV vault prolapse and uterovaginal prolapse apical repair was similar whether performed vaginally or abdominally at 1–2 years postoperatively.</description><identifier>ISSN: 0029-7844</identifier><identifier>EISSN: 1873-233X</identifier><identifier>DOI: 10.1097/AOG.0000000000002492</identifier><identifier>PMID: 29420409</identifier><language>eng</language><publisher>United States: Lippincott Williams & Wilkins</publisher><subject>Adult ; Aged ; Female ; Follow-Up Studies ; Gynecologic Surgical Procedures - methods ; Humans ; Middle Aged ; Quality of Life ; Retrospective Studies ; Treatment Outcome ; Uterine Prolapse - surgery</subject><ispartof>Obstetrics and gynecology (New York. 1953), 2018-03, Vol.131 (3), p.475-483</ispartof><rights>Lippincott Williams & Wilkins</rights><rights>2018 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5022-cb7ba50bdc8a0ed54a6bf6ebfc2ea490de74adc35ec8ffe922595b5ea0b4326c3</citedby><cites>FETCH-LOGICAL-c5022-cb7ba50bdc8a0ed54a6bf6ebfc2ea490de74adc35ec8ffe922595b5ea0b4326c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27922,27923</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29420409$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rogers, Rebecca G.</creatorcontrib><creatorcontrib>Nolen, Tracy L.</creatorcontrib><creatorcontrib>Weidner, Alison C.</creatorcontrib><creatorcontrib>Richter, Holly E.</creatorcontrib><creatorcontrib>Jelovsek, J. Eric</creatorcontrib><creatorcontrib>Shepherd, Jonathan P.</creatorcontrib><creatorcontrib>Harvie, Heidi S.</creatorcontrib><creatorcontrib>Brubaker, Linda</creatorcontrib><creatorcontrib>Menefee, Shawn A.</creatorcontrib><creatorcontrib>Myers, Deborah</creatorcontrib><creatorcontrib>Hsu, Yvonne</creatorcontrib><creatorcontrib>Schaffer, Joseph I.</creatorcontrib><creatorcontrib>Wallace, Dennis</creatorcontrib><creatorcontrib>Meikle, Susan F.</creatorcontrib><creatorcontrib>Eunice Kennedy Shriver National Institute of Child Health and Human Development Pelvic Floor Disorders Network</creatorcontrib><creatorcontrib>for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Pelvic Floor Disorders Network</creatorcontrib><title>Surgical Outcomes After Apical Repair for Vault Compared With Uterovaginal Prolapse</title><title>Obstetrics and gynecology (New York. 1953)</title><addtitle>Obstet Gynecol</addtitle><description>OBJECTIVE:To retrospectively compare surgical success and complications between vaginal vault prolapse compared with uterovaginal prolapse in women who underwent apical prolapse repair for stage II–IV prolapse.
METHODS:Women in one of three Pelvic Floor Disorders Network prolapse surgical trials were included. Absence of bothersome bulge symptoms, no prolapse beyond the hymen, and no subsequent prolapse treatment defined success and was our primary outcome. Secondary outcomes included comparison of quality-of-life measures, anatomic changes, and adverse events. Pelvic organ prolapse quantification (POP-Q) and quality-of-life measures were administered at baseline and 1–2 years postoperatively. Comparisons were controlled for study site, age, body mass index, baseline POP-Q, apical and anterior or posterior repair performed, and prior prolapse repair. Outcomes measured at multiple time points were analyzed using longitudinal models to assess whether differences existed across study follow-up.
RESULTS:Four hundred twenty-one women underwent vault prolapse, and 601 underwent uterovaginal prolapse apical repair. The vault prolapse group was older, more likely to be white, and to have prior urinary incontinence or prolapse repair, stage IV prolapse, and more prolapse bother on a validated scale (all P≤.034). The vault prolapse group was more likely to undergo sacrocolpopexy (228/421 [54%] vs 93/601 [15%]); the uterovaginal prolapse group was more likely to undergo vaginal repair (508/601 [85%] vs 193/421 [46%] P<.001). There were no differences in success (odds ratio [OR] 0.76 for vault prolapse vs uterovaginal prolapse, 95% CI 0.51–1.15, P=.20), changes in Pelvic Organ Prolapse Distress Inventory scores (−79.4 vs −79.8, P=.89), postoperative POP-Q point C measurements (−7.0 vs −7.1 cm, P=.41), or serious adverse events (86/421 [20%] vs 90/601 [15%], P=.86) between groups. Among women who underwent a vaginal approach for repair of vault prolapse (n=193) or uterovaginal prolapse (n=508), there were no differences in success rates (OR 0.67, 95% CI 0.43–1.04, P=.09) at 1–2 years postoperatively.
CONCLUSION:Surgical success of stage II–IV vault prolapse and uterovaginal prolapse apical repair was similar whether performed vaginally or abdominally at 1–2 years postoperatively.</description><subject>Adult</subject><subject>Aged</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gynecologic Surgical Procedures - methods</subject><subject>Humans</subject><subject>Middle Aged</subject><subject>Quality of Life</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><subject>Uterine Prolapse - surgery</subject><issn>0029-7844</issn><issn>1873-233X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU1P3DAQhq2Kqiwf_wChHLmEOv5I4gvSagXbSkhbFWi5WRNnshtw1sFOQP33eLsUQQ-tL5bHz_vOaF5CjjJ6mlFVfJ4u5qf0zWFCsQ9kkpUFTxnntztkEosqLUohdsleCHcRynLFP5FdpgSjgqoJuboa_bI1YJPFOBjXYUimzYA-mfa_q9-xh9YnjfPJDxjtkMxc14PHOvnZDqvkJqLuEZbtOrLfvLPQBzwgHxuwAQ9f7n1yc3F-PfuSXi7mX2fTy9RIylhqqqICSavalECxlgLyqsmxagxDEIrWWAioDZdoyqZBxZhUspIItBKc5Ybvk7Otbz9WHdYG14MHq3vfduB_aQetfv-zbld66R61LBkvchENTl4MvHsYMQy6a4NBa2GNbgyaxYXRvFBKRVRsUeNdCB6b1zYZ1Zs8dMxD_51HlB2_HfFV9CeACJRb4MnZuMtwb8cn9HqFYIfV_7zFP6QbLGeSpoxmJeXxlW7yp_wZ--KpRQ</recordid><startdate>201803</startdate><enddate>201803</enddate><creator>Rogers, Rebecca G.</creator><creator>Nolen, Tracy L.</creator><creator>Weidner, Alison C.</creator><creator>Richter, Holly E.</creator><creator>Jelovsek, J. Eric</creator><creator>Shepherd, Jonathan P.</creator><creator>Harvie, Heidi S.</creator><creator>Brubaker, Linda</creator><creator>Menefee, Shawn A.</creator><creator>Myers, Deborah</creator><creator>Hsu, Yvonne</creator><creator>Schaffer, Joseph I.</creator><creator>Wallace, Dennis</creator><creator>Meikle, Susan F.</creator><general>Lippincott Williams & Wilkins</general><general>by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201803</creationdate><title>Surgical Outcomes After Apical Repair for Vault Compared With Uterovaginal Prolapse</title><author>Rogers, Rebecca G. ; Nolen, Tracy L. ; Weidner, Alison C. ; Richter, Holly E. ; Jelovsek, J. Eric ; Shepherd, Jonathan P. ; Harvie, Heidi S. ; Brubaker, Linda ; Menefee, Shawn A. ; Myers, Deborah ; Hsu, Yvonne ; Schaffer, Joseph I. ; Wallace, Dennis ; Meikle, Susan F.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5022-cb7ba50bdc8a0ed54a6bf6ebfc2ea490de74adc35ec8ffe922595b5ea0b4326c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Gynecologic Surgical Procedures - methods</topic><topic>Humans</topic><topic>Middle Aged</topic><topic>Quality of Life</topic><topic>Retrospective Studies</topic><topic>Treatment Outcome</topic><topic>Uterine Prolapse - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rogers, Rebecca G.</creatorcontrib><creatorcontrib>Nolen, Tracy L.</creatorcontrib><creatorcontrib>Weidner, Alison C.</creatorcontrib><creatorcontrib>Richter, Holly E.</creatorcontrib><creatorcontrib>Jelovsek, J. Eric</creatorcontrib><creatorcontrib>Shepherd, Jonathan P.</creatorcontrib><creatorcontrib>Harvie, Heidi S.</creatorcontrib><creatorcontrib>Brubaker, Linda</creatorcontrib><creatorcontrib>Menefee, Shawn A.</creatorcontrib><creatorcontrib>Myers, Deborah</creatorcontrib><creatorcontrib>Hsu, Yvonne</creatorcontrib><creatorcontrib>Schaffer, Joseph I.</creatorcontrib><creatorcontrib>Wallace, Dennis</creatorcontrib><creatorcontrib>Meikle, Susan F.</creatorcontrib><creatorcontrib>Eunice Kennedy Shriver National Institute of Child Health and Human Development Pelvic Floor Disorders Network</creatorcontrib><creatorcontrib>for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Pelvic Floor Disorders Network</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Obstetrics and gynecology (New York. 1953)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rogers, Rebecca G.</au><au>Nolen, Tracy L.</au><au>Weidner, Alison C.</au><au>Richter, Holly E.</au><au>Jelovsek, J. Eric</au><au>Shepherd, Jonathan P.</au><au>Harvie, Heidi S.</au><au>Brubaker, Linda</au><au>Menefee, Shawn A.</au><au>Myers, Deborah</au><au>Hsu, Yvonne</au><au>Schaffer, Joseph I.</au><au>Wallace, Dennis</au><au>Meikle, Susan F.</au><aucorp>Eunice Kennedy Shriver National Institute of Child Health and Human Development Pelvic Floor Disorders Network</aucorp><aucorp>for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Pelvic Floor Disorders Network</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Surgical Outcomes After Apical Repair for Vault Compared With Uterovaginal Prolapse</atitle><jtitle>Obstetrics and gynecology (New York. 1953)</jtitle><addtitle>Obstet Gynecol</addtitle><date>2018-03</date><risdate>2018</risdate><volume>131</volume><issue>3</issue><spage>475</spage><epage>483</epage><pages>475-483</pages><issn>0029-7844</issn><eissn>1873-233X</eissn><abstract>OBJECTIVE:To retrospectively compare surgical success and complications between vaginal vault prolapse compared with uterovaginal prolapse in women who underwent apical prolapse repair for stage II–IV prolapse.
METHODS:Women in one of three Pelvic Floor Disorders Network prolapse surgical trials were included. Absence of bothersome bulge symptoms, no prolapse beyond the hymen, and no subsequent prolapse treatment defined success and was our primary outcome. Secondary outcomes included comparison of quality-of-life measures, anatomic changes, and adverse events. Pelvic organ prolapse quantification (POP-Q) and quality-of-life measures were administered at baseline and 1–2 years postoperatively. Comparisons were controlled for study site, age, body mass index, baseline POP-Q, apical and anterior or posterior repair performed, and prior prolapse repair. Outcomes measured at multiple time points were analyzed using longitudinal models to assess whether differences existed across study follow-up.
RESULTS:Four hundred twenty-one women underwent vault prolapse, and 601 underwent uterovaginal prolapse apical repair. The vault prolapse group was older, more likely to be white, and to have prior urinary incontinence or prolapse repair, stage IV prolapse, and more prolapse bother on a validated scale (all P≤.034). The vault prolapse group was more likely to undergo sacrocolpopexy (228/421 [54%] vs 93/601 [15%]); the uterovaginal prolapse group was more likely to undergo vaginal repair (508/601 [85%] vs 193/421 [46%] P<.001). There were no differences in success (odds ratio [OR] 0.76 for vault prolapse vs uterovaginal prolapse, 95% CI 0.51–1.15, P=.20), changes in Pelvic Organ Prolapse Distress Inventory scores (−79.4 vs −79.8, P=.89), postoperative POP-Q point C measurements (−7.0 vs −7.1 cm, P=.41), or serious adverse events (86/421 [20%] vs 90/601 [15%], P=.86) between groups. Among women who underwent a vaginal approach for repair of vault prolapse (n=193) or uterovaginal prolapse (n=508), there were no differences in success rates (OR 0.67, 95% CI 0.43–1.04, P=.09) at 1–2 years postoperatively.
CONCLUSION:Surgical success of stage II–IV vault prolapse and uterovaginal prolapse apical repair was similar whether performed vaginally or abdominally at 1–2 years postoperatively.</abstract><cop>United States</cop><pub>Lippincott Williams & Wilkins</pub><pmid>29420409</pmid><doi>10.1097/AOG.0000000000002492</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Obstetrics and gynecology (New York. 1953), 2018-03, Vol.131 (3), p.475-483 |
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| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5823764 |
| source | MEDLINE; Journals@Ovid Complete |
| subjects | Adult Aged Female Follow-Up Studies Gynecologic Surgical Procedures - methods Humans Middle Aged Quality of Life Retrospective Studies Treatment Outcome Uterine Prolapse - surgery |
| title | Surgical Outcomes After Apical Repair for Vault Compared With Uterovaginal Prolapse |
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