High Uterosacral Ligament Suspension with Nonabsorbable Sutures in Apical Prolapse: A 24-Month Follow-Up

Rodolfo E. Lopez-Orellana, Francisco J. Kaplan-Delmar, Andres I. Yuivar-Santana, Tiare A. Hevia-Grez
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Abstract

Background: Pelvic organ prolapse (POP) is a common pathology affecting up to 60% of women. Transvaginal high uterosacral ligament suspension (HUSLS) is an alternative treatment for apical prolapse. HUSLS has short operative and recovery time, as well as low complication rate. Objective: To evaluate the objective and subjective success rates in patients with apical prolapse who underwent HUSLS at Quilpué Hospital over a 24-month follow-up. Materials: A retrospective, observational, descriptive study was carried out, and all symptomatic patients with apical prolapse ? stage 2 POP-Q classification who underwent HUSLS between September 2014 and October 2019 were included in the study. Data were obtained from the database of the Urogynecology Unit of Quilpué Hospital, after approval by the ethics committee. Objective success was defined as C-point at 1 cm above the hymen, while subjective success was defined as “better” or “much better” in the Patient Global Impression of Improvement (PGI-I) scale and/or a visual analog scale (VAS) greater than 80% at 24 months of follow-up. Results: Of the 46 patients included in the study, the objective success rate was 84%, while the subjective success rate was 70%. Conclusion: Transvaginal HUSLS with permanent sutures is an excellent alternative treatment for apical prolapse, with a success rate similar to the gold standard at 24 months follow-up.
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高位子宫骶韧带悬吊术治疗根尖脱垂:24个月随访
背景:盆腔器官脱垂(POP)是一种常见的病理,影响多达60%的女性。经阴道高位子宫骶韧带悬吊术(HUSLS)是根尖脱垂的另一种治疗方法。手术时间短,恢复时间短,并发症发生率低。目的:通过24个月的随访,评价在quilpu医院行根尖脱垂手术的患者的主观和客观成功率。资料:回顾性、观察性、描述性研究,所有有症状的根尖脱垂患者?在2014年9月至2019年10月期间接受HUSLS的第二阶段POP-Q分类纳入研究。经伦理委员会批准,数据来源于quilpu医院泌尿妇科数据库。客观成功定义为处女膜上方1 cm处的c点,而主观成功定义为患者总体改善印象(PGI-I)量表和/或视觉模拟量表(VAS)在24个月随访时大于80%时“更好”或“更好”。结果:纳入研究的46例患者,客观成功率为84%,主观成功率为70%。结论:经阴道阴道脱垂联合永久缝合线是治疗根尖脱垂的一种很好的替代方法,随访24个月成功率接近金标准。
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