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Positive symptom improvement with laparoscopic uterosacral ligament repair for uterine or vaginal vault prolapse: interim results from an active multicenter trial.
J Minim Invasive Gynecol. 2007 Sep-Oct; 14(5):570-6.JM

Abstract

STUDY OBJECTIVE

To evaluate the use of laparoscopic uterosacral ligament repair for long-term patient symptom improvement in patients with uterine prolapse or posthysterectomy vaginal vault prolapse and to evaluate how laparoscopic instrumentation kits facilitate procedure performance for the surgeon.

DESIGN

Nonrandomized, prospective, multicenter case series (Canadian Task Force classification II-2).

SETTING

Five clinical sites consisting of 4 community hospitals and 1 university medical center.

PATIENTS

Seventy-two patients with stage II or worse uterine prolapse (58%, n = 42) or posthysterectomy vaginal vault prolapse (42%, n = 30). One patient with stage I vaginal vault prolapse was included in the group due to her significant symptoms.

INTERVENTIONS

Laparoscopic uterosacral ligament repair was performed on all patients; round ligament truncation was also performed selectively on patients with uterine prolapse. Fifty-seven percent (41 patients) had concomitant pelvic procedures.

MEASUREMENTS AND MAIN RESULTS

At 12-month follow-up, Pelvic Organ Prolapse Quantification (POP-Q) scores and patient self-reported symptom scores were significantly improved over baseline after laparoscopic repair of pelvic organ prolapse. Positive mean change in POP-Q score was 14.4 (p = .0003) for uterine prolapse repair and 9.28 (p = .017) for vaginal vault prolapse repair. Positive mean change in total symptom score was 20.36 (p <.0001) for uterine prolapse repair and 11.43 (p = .005) for vaginal vault prolapse repair. Surgeons reported a mean procedure time of 31.6 minutes for uterine prolapse repair and 21.7 minutes for vaginal vault prolapse repair. A mean rating of 7.5 was documented for ease of use for the uterine prolapse kit and 4.1 for the vaginal vault prolapse kit on a scale of 1 to 10.

CONCLUSION

Laparoscopic uterosacral ligament repair improves symptoms and POP-Q scores over the long term in patients with uterine or vaginal vault prolapse. Laparoscopic instrumentation kits facilitate procedure performance for the surgeon with expedited surgery times.

Authors+Show Affiliations

Schwartz M
Lifeline Medical Associates, Piscataway, New Jersey 08854, USA. tricountyobg@aol.com
Abbott KR
No affiliation info available
Glazerman L
No affiliation info available
Sobolewski C
No affiliation info available
Jarnagin B
No affiliation info available
Ailawadi R
No affiliation info available
Lucente V
No affiliation info available

MeSH

AdultAgedFemaleFollow-Up StudiesGynecologic Surgical ProceduresHumansLaparoscopyMiddle AgedPatient SatisfactionProspective StudiesRound Ligament of UterusSeverity of Illness IndexSuture TechniquesUterine Prolapse

Pub Type(s)

Clinical Trial
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17848317

Citation

Schwartz, Marlan, et al. "Positive Symptom Improvement With Laparoscopic Uterosacral Ligament Repair for Uterine or Vaginal Vault Prolapse: Interim Results From an Active Multicenter Trial." Journal of Minimally Invasive Gynecology, vol. 14, no. 5, 2007, pp. 570-6.
Schwartz M, Abbott KR, Glazerman L, et al. Positive symptom improvement with laparoscopic uterosacral ligament repair for uterine or vaginal vault prolapse: interim results from an active multicenter trial. J Minim Invasive Gynecol. 2007;14(5):570-6.
Schwartz, M., Abbott, K. R., Glazerman, L., Sobolewski, C., Jarnagin, B., Ailawadi, R., & Lucente, V. (2007). Positive symptom improvement with laparoscopic uterosacral ligament repair for uterine or vaginal vault prolapse: interim results from an active multicenter trial. Journal of Minimally Invasive Gynecology, 14(5), 570-6.
Schwartz M, et al. Positive Symptom Improvement With Laparoscopic Uterosacral Ligament Repair for Uterine or Vaginal Vault Prolapse: Interim Results From an Active Multicenter Trial. J Minim Invasive Gynecol. 2007 Sep-Oct;14(5):570-6. PubMed PMID: 17848317.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Positive symptom improvement with laparoscopic uterosacral ligament repair for uterine or vaginal vault prolapse: interim results from an active multicenter trial. AU - Schwartz,Marlan, AU - Abbott,Karen Rae, AU - Glazerman,Larry, AU - Sobolewski,Craig, AU - Jarnagin,Barry, AU - Ailawadi,Radhika, AU - Lucente,Vincent, PY - 2006/10/28/received PY - 2007/01/12/revised PY - 2007/01/22/accepted PY - 2007/9/13/pubmed PY - 2007/12/15/medline PY - 2007/9/13/entrez SP - 570 EP - 6 JF - Journal of minimally invasive gynecology JO - J Minim Invasive Gynecol VL - 14 IS - 5 N2 - STUDY OBJECTIVE: To evaluate the use of laparoscopic uterosacral ligament repair for long-term patient symptom improvement in patients with uterine prolapse or posthysterectomy vaginal vault prolapse and to evaluate how laparoscopic instrumentation kits facilitate procedure performance for the surgeon. DESIGN: Nonrandomized, prospective, multicenter case series (Canadian Task Force classification II-2). SETTING: Five clinical sites consisting of 4 community hospitals and 1 university medical center. PATIENTS: Seventy-two patients with stage II or worse uterine prolapse (58%, n = 42) or posthysterectomy vaginal vault prolapse (42%, n = 30). One patient with stage I vaginal vault prolapse was included in the group due to her significant symptoms. INTERVENTIONS: Laparoscopic uterosacral ligament repair was performed on all patients; round ligament truncation was also performed selectively on patients with uterine prolapse. Fifty-seven percent (41 patients) had concomitant pelvic procedures. MEASUREMENTS AND MAIN RESULTS: At 12-month follow-up, Pelvic Organ Prolapse Quantification (POP-Q) scores and patient self-reported symptom scores were significantly improved over baseline after laparoscopic repair of pelvic organ prolapse. Positive mean change in POP-Q score was 14.4 (p = .0003) for uterine prolapse repair and 9.28 (p = .017) for vaginal vault prolapse repair. Positive mean change in total symptom score was 20.36 (p <.0001) for uterine prolapse repair and 11.43 (p = .005) for vaginal vault prolapse repair. Surgeons reported a mean procedure time of 31.6 minutes for uterine prolapse repair and 21.7 minutes for vaginal vault prolapse repair. A mean rating of 7.5 was documented for ease of use for the uterine prolapse kit and 4.1 for the vaginal vault prolapse kit on a scale of 1 to 10. CONCLUSION: Laparoscopic uterosacral ligament repair improves symptoms and POP-Q scores over the long term in patients with uterine or vaginal vault prolapse. Laparoscopic instrumentation kits facilitate procedure performance for the surgeon with expedited surgery times. SN - 1553-4650 UR - https://www.unboundmedicine.com/medline/citation/17848317/Positive_symptom_improvement_with_laparoscopic_uterosacral_ligament_repair_for_uterine_or_vaginal_vault_prolapse:_interim_results_from_an_active_multicenter_trial_ DB - PRIME DP - Unbound Medicine ER -