Abstract
STUDY OBJECTIVE
To compare the change from pre- to postoperative total vaginal length (TVL) in women who underwent either a total vaginal hysterectomy (TVH) with uterosacral ligament suspension (USLS) or a robotic hysterectomy (RH) with colpopexy (SCP). Secondary objectives included comparing sexual function, pelvic floor function, and prolapse recurrence between routes of surgery.
DESIGN
This was a retrospective cohort study (Canadian Task Force classification II-2).
SETTING
This was conducted at 1 tertiary academic medical center over a 2-year period.
PATIENTS
Women who underwent either TVH/USLS or RH/SCP.
INTERVENTIONS
Baseline and postoperative POP-Q Pelvic Organ Prolapse Quantification exams were recorded as well as postoperative validated questionnaires. Twenty-nine subjects were needed in each group to detect a 1.5-cm difference in TVL.
MEASUREMENTS AND MAIN RESULTS
There were 38 TVH/USLS and 46 RH/SCP participants. RHs were either total (28/46 [61%]) or supracervical (18/46 [39%]). The mean postoperative follow-up was 9.5 ± 3.1 months. For the primary outcome, women in the TVH/USLS group had a decrease in TVL, whereas women in the RH/SCP group had an increase in TVL (-0.6 ± 1.0 cm vs 0.5 ± 0.8 cm, p < .001). Among sexually active women (55/84, 65.5%), there was no difference in postoperative sexual function between groups based on Pelvic Organ Prolapse/Urinary incontinence Sexual Function Questionnaire short form scores, with good sexual function in both groups (32.6 ± 6.2 TVH/USLS vs 35.1 ± 7.3 RH/SCP, p = .22). Although both groups showed good postoperative apical support, the TVH/USLS group had a slightly lower mean C point compared with the RH/SCP group (-6.8 ± 1.2 vs -7.7 ± 1.8, p = .02). Both groups showed good postoperative pelvic floor function, with no difference in mean postoperative Pelvic Organ Prolapse Distress Inventory scores (42.2 ± 45.4 vs 52.7 ± 46.6, p = .44). Recurrent prolapse (defined as any prolapse at or beyond the hymen) was not different between groups (13.2% for TVH/USLS vs 6.5% for RH/SCP, p = .46).
CONCLUSION
Vaginal length decreased after vaginal hysterectomy with pelvic support surgery compared with RH with pelvic support surgery, with no differences in postoperative sexual function or pelvic floor function between groups.
TY - JOUR
T1 - Vaginal versus robotic hysterectomy and concomitant pelvic support surgery: a comparison of postoperative vaginal length and sexual function.
AU - De La Cruz,Jacquia F,
AU - Myers,Erinn M,
AU - Geller,Elizabeth J,
Y1 - 2014/04/26/
PY - 2014/02/18/received
PY - 2014/04/10/revised
PY - 2014/04/17/accepted
PY - 2014/5/1/entrez
PY - 2014/5/2/pubmed
PY - 2015/6/5/medline
KW - Robotic hysterectomy
KW - Sacrocolpopexy
KW - Sexual function
KW - Vaginal hysterectomy
KW - Vaginal length
SP - 1010
EP - 4
JF - Journal of minimally invasive gynecology
JO - J Minim Invasive Gynecol
VL - 21
IS - 6
N2 - STUDY OBJECTIVE: To compare the change from pre- to postoperative total vaginal length (TVL) in women who underwent either a total vaginal hysterectomy (TVH) with uterosacral ligament suspension (USLS) or a robotic hysterectomy (RH) with colpopexy (SCP). Secondary objectives included comparing sexual function, pelvic floor function, and prolapse recurrence between routes of surgery. DESIGN: This was a retrospective cohort study (Canadian Task Force classification II-2). SETTING: This was conducted at 1 tertiary academic medical center over a 2-year period. PATIENTS: Women who underwent either TVH/USLS or RH/SCP. INTERVENTIONS: Baseline and postoperative POP-Q Pelvic Organ Prolapse Quantification exams were recorded as well as postoperative validated questionnaires. Twenty-nine subjects were needed in each group to detect a 1.5-cm difference in TVL. MEASUREMENTS AND MAIN RESULTS: There were 38 TVH/USLS and 46 RH/SCP participants. RHs were either total (28/46 [61%]) or supracervical (18/46 [39%]). The mean postoperative follow-up was 9.5 ± 3.1 months. For the primary outcome, women in the TVH/USLS group had a decrease in TVL, whereas women in the RH/SCP group had an increase in TVL (-0.6 ± 1.0 cm vs 0.5 ± 0.8 cm, p < .001). Among sexually active women (55/84, 65.5%), there was no difference in postoperative sexual function between groups based on Pelvic Organ Prolapse/Urinary incontinence Sexual Function Questionnaire short form scores, with good sexual function in both groups (32.6 ± 6.2 TVH/USLS vs 35.1 ± 7.3 RH/SCP, p = .22). Although both groups showed good postoperative apical support, the TVH/USLS group had a slightly lower mean C point compared with the RH/SCP group (-6.8 ± 1.2 vs -7.7 ± 1.8, p = .02). Both groups showed good postoperative pelvic floor function, with no difference in mean postoperative Pelvic Organ Prolapse Distress Inventory scores (42.2 ± 45.4 vs 52.7 ± 46.6, p = .44). Recurrent prolapse (defined as any prolapse at or beyond the hymen) was not different between groups (13.2% for TVH/USLS vs 6.5% for RH/SCP, p = .46). CONCLUSION: Vaginal length decreased after vaginal hysterectomy with pelvic support surgery compared with RH with pelvic support surgery, with no differences in postoperative sexual function or pelvic floor function between groups.
SN - 1553-4669
UR - https://www.unboundmedicine.com/medline/citation/24780383/Vaginal_versus_robotic_hysterectomy_and_concomitant_pelvic_support_surgery:_a_comparison_of_postoperative_vaginal_length_and_sexual_function_
DB - PRIME
DP - Unbound Medicine
ER -
