Skip to main content

Surgical Outcomes After Apical Repair for Vault Compared With Uterovaginal Prolapse.

Publication ,  Journal Article
Rogers, RG; Nolen, TL; Weidner, AC; Richter, HE; Jelovsek, JE; Shepherd, JP; Harvie, HS; Brubaker, L; Menefee, SA; Myers, D; Hsu, Y ...
Published in: Obstet Gynecol
March 2018

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.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Obstet Gynecol

DOI

EISSN

1873-233X

Publication Date

March 2018

Volume

131

Issue

3

Start / End Page

475 / 483

Location

United States

Related Subject Headings

  • Uterine Prolapse
  • Treatment Outcome
  • Retrospective Studies
  • Quality of Life
  • Obstetrics & Reproductive Medicine
  • Middle Aged
  • Humans
  • Gynecologic Surgical Procedures
  • Follow-Up Studies
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Rogers, R. G., Nolen, T. L., Weidner, A. C., Richter, H. E., Jelovsek, J. E., Shepherd, J. P., … Eunice Kennedy Shriver National Institute of Child Health and Human Development Pelvic Floor Disorders Network. (2018). Surgical Outcomes After Apical Repair for Vault Compared With Uterovaginal Prolapse. Obstet Gynecol, 131(3), 475–483. https://doi.org/10.1097/AOG.0000000000002492
Rogers, Rebecca G., Tracy L. Nolen, Alison C. Weidner, Holly E. Richter, J Eric Jelovsek, Jonathan P. Shepherd, Heidi S. Harvie, et al. “Surgical Outcomes After Apical Repair for Vault Compared With Uterovaginal Prolapse.Obstet Gynecol 131, no. 3 (March 2018): 475–83. https://doi.org/10.1097/AOG.0000000000002492.
Rogers RG, Nolen TL, Weidner AC, Richter HE, Jelovsek JE, Shepherd JP, et al. Surgical Outcomes After Apical Repair for Vault Compared With Uterovaginal Prolapse. Obstet Gynecol. 2018 Mar;131(3):475–83.
Rogers, Rebecca G., et al. “Surgical Outcomes After Apical Repair for Vault Compared With Uterovaginal Prolapse.Obstet Gynecol, vol. 131, no. 3, Mar. 2018, pp. 475–83. Pubmed, doi:10.1097/AOG.0000000000002492.
Rogers RG, Nolen TL, Weidner AC, Richter HE, Jelovsek JE, Shepherd JP, Harvie HS, Brubaker L, Menefee SA, Myers D, Hsu Y, Schaffer JI, Wallace D, Meikle SF, Eunice Kennedy Shriver National Institute of Child Health and Human Development Pelvic Floor Disorders Network. Surgical Outcomes After Apical Repair for Vault Compared With Uterovaginal Prolapse. Obstet Gynecol. 2018 Mar;131(3):475–483.

Published In

Obstet Gynecol

DOI

EISSN

1873-233X

Publication Date

March 2018

Volume

131

Issue

3

Start / End Page

475 / 483

Location

United States

Related Subject Headings

  • Uterine Prolapse
  • Treatment Outcome
  • Retrospective Studies
  • Quality of Life
  • Obstetrics & Reproductive Medicine
  • Middle Aged
  • Humans
  • Gynecologic Surgical Procedures
  • Follow-Up Studies
  • Female