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Association Between Enlarged Genital Hiatus and Composite Surgical Failure After Vaginal Hysterectomy With Uterosacral Ligament Suspension.

Publication ,  Journal Article
Bradley, MS; Sridhar, A; Ferrante, K; Andy, UU; Visco, AG; Florian-Rodriguez, ME; Myers, D; Varner, E; Mazloomdoost, D; Gantz, MG ...
Published in: Urogynecology (Phila)
May 1, 2023

IMPORTANCE: The impact of a persistently enlarged genital hiatus (GH) after vaginal hysterectomy with uterosacral ligament suspension on prolapse outcomes is currently unclear. OBJECTIVES: This secondary analysis of the Study of Uterine Prolapse Procedures Randomized trial was conducted among participants who underwent vaginal hysterectomy with uterosacral ligament suspension. We hypothesized that women with a persistently enlarged GH size would have a higher proportion of prolapse recurrence. STUDY DESIGN: Women who underwent vaginal hysterectomy with uterosacral ligament suspension as part of the Study of Uterine Prolapse Procedures Randomized trial (NCT01802281) were divided into 3 groups based on change in their preoperative to 4- to 6-week postoperative GH measurements: (1) persistently enlarged GH, 2) improved GH, or (3) stably normal GH. Baseline characteristics and 2-year surgical outcomes were compared across groups. A logistic regression model for composite surgical failure controlling for advanced anterior wall prolapse and GH group was fitted. RESULTS: This secondary analysis included 81 women. The proportion with composite surgical failure was significantly higher among those with a persistently enlarged GH (50%) compared with a stably normal GH (12%) with an unadjusted risk difference of 38% (95% confidence interval, 4%-68%). When adjusted for advanced prolapse in the anterior compartment at baseline, the odds of composite surgical failure was 6 times higher in the persistently enlarged GH group compared with the stably normal group (95% confidence interval, 1.0-37.5; P = 0.06). CONCLUSION: A persistently enlarged GH after vaginal hysterectomy with uterosacral ligament suspension for pelvic organ prolapse may be a risk factor for recurrent prolapse.

Duke Scholars

Published In

Urogynecology (Phila)

DOI

EISSN

2771-1897

Publication Date

May 1, 2023

Volume

29

Issue

5

Start / End Page

479 / 488

Location

United States

Related Subject Headings

  • Uterus
  • Uterine Prolapse
  • Pelvic Organ Prolapse
  • Ligaments
  • Hysterectomy, Vaginal
  • Humans
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Bradley, M. S., Sridhar, A., Ferrante, K., Andy, U. U., Visco, A. G., Florian-Rodriguez, M. E., … NICHD Pelvic Floor Disorders Network, . (2023). Association Between Enlarged Genital Hiatus and Composite Surgical Failure After Vaginal Hysterectomy With Uterosacral Ligament Suspension. Urogynecology (Phila), 29(5), 479–488. https://doi.org/10.1097/SPV.0000000000001309
Bradley, Megan S., Amaanti Sridhar, Kimberly Ferrante, Uduak U. Andy, Anthony G. Visco, Maria E. Florian-Rodriguez, Deborah Myers, et al. “Association Between Enlarged Genital Hiatus and Composite Surgical Failure After Vaginal Hysterectomy With Uterosacral Ligament Suspension.Urogynecology (Phila) 29, no. 5 (May 1, 2023): 479–88. https://doi.org/10.1097/SPV.0000000000001309.
Bradley MS, Sridhar A, Ferrante K, Andy UU, Visco AG, Florian-Rodriguez ME, et al. Association Between Enlarged Genital Hiatus and Composite Surgical Failure After Vaginal Hysterectomy With Uterosacral Ligament Suspension. Urogynecology (Phila). 2023 May 1;29(5):479–88.
Bradley, Megan S., et al. “Association Between Enlarged Genital Hiatus and Composite Surgical Failure After Vaginal Hysterectomy With Uterosacral Ligament Suspension.Urogynecology (Phila), vol. 29, no. 5, May 2023, pp. 479–88. Pubmed, doi:10.1097/SPV.0000000000001309.
Bradley MS, Sridhar A, Ferrante K, Andy UU, Visco AG, Florian-Rodriguez ME, Myers D, Varner E, Mazloomdoost D, Gantz MG, NICHD Pelvic Floor Disorders Network. Association Between Enlarged Genital Hiatus and Composite Surgical Failure After Vaginal Hysterectomy With Uterosacral Ligament Suspension. Urogynecology (Phila). 2023 May 1;29(5):479–488.

Published In

Urogynecology (Phila)

DOI

EISSN

2771-1897

Publication Date

May 1, 2023

Volume

29

Issue

5

Start / End Page

479 / 488

Location

United States

Related Subject Headings

  • Uterus
  • Uterine Prolapse
  • Pelvic Organ Prolapse
  • Ligaments
  • Hysterectomy, Vaginal
  • Humans
  • Female