Medium-term outcomes after combined trachelectomy and uterosacral ligament suspension among young women with severe uterine prolapse

Int J Gynaecol Obstet. 2016 Feb;132(2):224-8. doi: 10.1016/j.ijgo.2015.07.012. Epub 2015 Nov 6.

Abstract

Objective: To evaluate anatomic and sexual outcomes among young women with severe pelvic organ prolapse undergoing combined trachelectomy and laparoscopic high uterosacral ligament suspension (LHUS).

Methods: In a prospective study in Beijing, China, patients (aged ≤50 years) with pelvic organ prolapse of stage III or higher according to the Pelvic Organ Prolapse Quantification (POP-Q) were enrolled between November 2007 and August 2011. After combined trachelectomy and LHUS, patients were followed up at 6 weeks, 6 months, 12 months, and yearly thereafter. Anatomic success was defined as POP-Q lower than stage II. Sexual outcomes were assessed at 6 months via the validated Short-Form Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12), and compared with a control group of 39 healthy age-matched women.

Results: Among 49 patients, surgical success and patient satisfaction rates were 100% after a median follow-up of 54 months. Among 48 patients who were sexually active at follow-up, 39 (81%) completed the PISQ-12 questionnaire. The 6-month PISQ-12 score was higher than the preoperative score overall (38.1 vs 26.4, P<0.001) and for all three subscale domains (P≤0.001). The PISQ-12 score of postoperative patients was similar to that of control women (36.8, P=0.52).

Conclusion: Trachelectomy combined with LHUS produced satisfactory medium-term anatomic and functional outcomes for young women with severe uterine prolapse.

Keywords: Clinical outcome; High uterosacral ligament suspension; Laparoscopy; Severe; Uterine prolapse.

MeSH terms

  • Adult
  • Beijing
  • Case-Control Studies
  • Combined Modality Therapy
  • Female
  • Follow-Up Studies
  • Gynecologic Surgical Procedures / methods
  • Gynecologic Surgical Procedures / psychology*
  • Humans
  • Laparoscopy / methods
  • Laparoscopy / psychology*
  • Ligaments / surgery
  • Middle Aged
  • Patient Satisfaction
  • Postoperative Period
  • Prospective Studies
  • Sacrococcygeal Region / surgery
  • Severity of Illness Index
  • Sexual Behavior / psychology*
  • Surveys and Questionnaires
  • Trachelectomy / psychology*
  • Treatment Outcome
  • Uterine Prolapse / psychology*
  • Uterine Prolapse / surgery
  • Uterus / surgery