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Int Urogynecol J. 2017 Sep;28(9):1285-1294. doi: 10.1007/s00192-017-3291-x. Epub 2017 Mar 3.

Sacrospinous hysteropexy: review and meta-analysis of outcomes.

Author information

1
Ipswich Hospital, QLD Health, University of Queensland, Chelmsford Avenue, Ipswich, QLD, 4305, Australia.
2
Ipswich Hospital, QLD Health, University of Queensland, Chelmsford Avenue, Ipswich, QLD, 4305, Australia. sivanezan@gmail.com.
3
Lady Cilento Children's Hospital, QLD Health, University of Queensland, South Brisbane, QLD, Australia.

Abstract

INTRODUCTION:

Sacrospinous hysteropexy is a uterine-preserving procedure for treatment of apical prolapse. We present a literature review evaluating the sacrospinous hysteropexy procedure and its current place in the surgical management of pelvic organ prolapse. Additionally, to assess the efficacy of the procedure, we performed a meta-analysis of studies comparing sacrospinous hysteropexy to vaginal hysterectomy and repair in terms of anatomical outcomes, complications, and repeat surgery.

METHODS:

Major literature databases including MEDLINE (1946 to 2 April 2016), Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 3), and Embase (1947 to 2 April 2016) were searched for relevant studies. We used Cochrane Collaboration's Review Manager software to perform meta-analysis of randomized controlled studies and observational studies.

RESULTS:

Vaginal sacrospinous hysteropexy was first performed in 1989 and is similar in technique to sacrospinous colpopexy. Two randomized controlled trials and four cohort studies (nā€‰=ā€‰651) were included in the meta-analysis. Apical failure rates after sacrospinous hysteropexy versus vaginal hysterectomy were not significantly different, although the trend favored vaginal hysterectomy [odds ratio (OR) 2.08; 95% confidence interval (CI) 0.76-5.68]. Rates of repeat surgery for prolapse were not significantly different between the two groups (OR 0.99; 95% CI 0.41-2.37). The most significant disadvantage of uterine-preservation prolapse surgery when compared with hysterectomy is the lack of prevention and diagnosis of uterine malignancy.

CONCLUSION:

Sacrospinous hysteropexy is a safe and effective procedure for pelvic organ prolapse and has comparable outcomes to vaginal hysterectomy with repair.

KEYWORDS:

Apical prolapse; Sacrospinous hysteropexy; Uterine preservation; Vaginal hysterectomy

PMID:
28258346
DOI:
10.1007/s00192-017-3291-x
[Indexed for MEDLINE]

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