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Laparoscopic Cerclage Sacrohysteropexy: Comparing a Novel Technique for Sacrohysteropexy to Traditional Supracervical Hysterectomy and Sacrocervicopexy.
Female Pelvic Med Reconstr Surg. 2021 02 01; 27(2):e315-e320.FP

Abstract

OBJECTIVE

The objective of this study was to compare outcomes of laparoscopic cerclage sacrohysteropexy (LCSH), a novel technique used to perform sacrohysteropexy, which requires significantly less suturing and knot tying, to traditional laparoscopic supracervical hysterectomy (LSH) with sacrocervicopexy for the treatment of uterine prolapse.

METHODS

This is a retrospective cohort study of all patients who underwent LCSH between March 3, 2016, and October 30, 2018, and patients who underwent LSH with sacrocervicopexy between September 1, 2013, and October 30, 2018. Medical records were reviewed to obtain information on baseline demographics, preoperative pelvic organ prolapse quantification (POP-Q), baseline Pelvic Floor Distress Inventory score, and intraoperative and postoperative outcomes. Apical failure was defined as descent of the cervix beyond the midvagina (C > -TVL/2). Subjective failure was defined as reporting of bulge symptoms, reoperation, or use of a vaginal pessary.

RESULTS

Seventy-seven patients who underwent the LCSH procedure and 88 who underwent LSH with sacrocervicopexy were identified. Baseline demographic data were similar between the 2 groups. Operating time was significantly decreased in the LCSH group with median time of 129 minutes (interquartile range, 121-153) versus 199 minutes (interquartile range, 178.5-222.5; P < 0.001) in the traditional cohort. Six weeks after surgery, patients had equivalent POP-Q examinations and Pelvic Floor Distress Inventory scores. At 6 months after surgery, patients similarly had no significant difference in POP-Q examination or scores on standardized questionnaires between the 2 groups. There were no mesh or suture erosions noted in either cohort at any time point.

CONCLUSIONS

Laparoscopic cerclage sacrohysteropexy is a novel variation of traditional sacrohysteropexy and an alternative to LSH with sacrocervicopexy that minimizes the dissection and suturing required. This procedure appears to offer equivalent anatomic and subjective outcomes to traditional LSH with sacrocervicopexy with significantly decreased intraoperative time.

Authors

No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

32675629

Citation

Armstrong, Katherine L., et al. "Laparoscopic Cerclage Sacrohysteropexy: Comparing a Novel Technique for Sacrohysteropexy to Traditional Supracervical Hysterectomy and Sacrocervicopexy." Female Pelvic Medicine & Reconstructive Surgery, vol. 27, no. 2, 2021, pp. e315-e320.
Armstrong KL, Modest AM, Rosenblatt PL. Laparoscopic Cerclage Sacrohysteropexy: Comparing a Novel Technique for Sacrohysteropexy to Traditional Supracervical Hysterectomy and Sacrocervicopexy. Female Pelvic Med Reconstr Surg. 2021;27(2):e315-e320.
Armstrong, K. L., Modest, A. M., & Rosenblatt, P. L. (2021). Laparoscopic Cerclage Sacrohysteropexy: Comparing a Novel Technique for Sacrohysteropexy to Traditional Supracervical Hysterectomy and Sacrocervicopexy. Female Pelvic Medicine & Reconstructive Surgery, 27(2), e315-e320. https://doi.org/10.1097/SPV.0000000000000917
Armstrong KL, Modest AM, Rosenblatt PL. Laparoscopic Cerclage Sacrohysteropexy: Comparing a Novel Technique for Sacrohysteropexy to Traditional Supracervical Hysterectomy and Sacrocervicopexy. Female Pelvic Med Reconstr Surg. 2021 02 1;27(2):e315-e320. PubMed PMID: 32675629.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Laparoscopic Cerclage Sacrohysteropexy: Comparing a Novel Technique for Sacrohysteropexy to Traditional Supracervical Hysterectomy and Sacrocervicopexy. AU - Armstrong,Katherine L, AU - Modest,Anna M, AU - Rosenblatt,Peter L, PY - 2020/7/18/pubmed PY - 2021/12/15/medline PY - 2020/7/18/entrez SP - e315 EP - e320 JF - Female pelvic medicine & reconstructive surgery JO - Female Pelvic Med Reconstr Surg VL - 27 IS - 2 N2 - OBJECTIVE: The objective of this study was to compare outcomes of laparoscopic cerclage sacrohysteropexy (LCSH), a novel technique used to perform sacrohysteropexy, which requires significantly less suturing and knot tying, to traditional laparoscopic supracervical hysterectomy (LSH) with sacrocervicopexy for the treatment of uterine prolapse. METHODS: This is a retrospective cohort study of all patients who underwent LCSH between March 3, 2016, and October 30, 2018, and patients who underwent LSH with sacrocervicopexy between September 1, 2013, and October 30, 2018. Medical records were reviewed to obtain information on baseline demographics, preoperative pelvic organ prolapse quantification (POP-Q), baseline Pelvic Floor Distress Inventory score, and intraoperative and postoperative outcomes. Apical failure was defined as descent of the cervix beyond the midvagina (C > -TVL/2). Subjective failure was defined as reporting of bulge symptoms, reoperation, or use of a vaginal pessary. RESULTS: Seventy-seven patients who underwent the LCSH procedure and 88 who underwent LSH with sacrocervicopexy were identified. Baseline demographic data were similar between the 2 groups. Operating time was significantly decreased in the LCSH group with median time of 129 minutes (interquartile range, 121-153) versus 199 minutes (interquartile range, 178.5-222.5; P < 0.001) in the traditional cohort. Six weeks after surgery, patients had equivalent POP-Q examinations and Pelvic Floor Distress Inventory scores. At 6 months after surgery, patients similarly had no significant difference in POP-Q examination or scores on standardized questionnaires between the 2 groups. There were no mesh or suture erosions noted in either cohort at any time point. CONCLUSIONS: Laparoscopic cerclage sacrohysteropexy is a novel variation of traditional sacrohysteropexy and an alternative to LSH with sacrocervicopexy that minimizes the dissection and suturing required. This procedure appears to offer equivalent anatomic and subjective outcomes to traditional LSH with sacrocervicopexy with significantly decreased intraoperative time. SN - 2154-4212 UR - https://www.unboundmedicine.com/medline/citation/32675629/Laparoscopic_Cerclage_Sacrohysteropexy:_Comparing_a_Novel_Technique_for_Sacrohysteropexy_to_Traditional_Supracervical_Hysterectomy_and_Sacrocervicopexy_ DB - PRIME DP - Unbound Medicine ER -