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Park, Yoo, and Lee: Efficacy and safety of uterosacral ligament vaginal vault suspension and levator myorrhaphy for pelvic organ prolapse
Original Article
Korean Journal of Obstetrics & Gynecology

Korean Journal of Obstetrics & Gynecology 2011; 54(8): 454-458.

Published online: 25 August 2011

DOI: https://doi.org/10.5468/KJOG.2011.54.8.454

Efficacy and safety of uterosacral ligament vaginal vault suspension and levator myorrhaphy for pelvic organ prolapse

Han-Young Park, MD, Eun-Hee Yoo, MD, Sun-Kyung Lee, MD

Department of Obstetrics and Gynecology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea.

Corresponding author: Eun-Hee Yoo, MD. Department of Obstetrics and Gynecology, Kyung Hee University at Gandong, Kyung Hee University College of Medicine, 149 Sangil-dong, Gangdong-gu, Seoul 134-727, Korea. Tel: +82-2-440-6141, Fax: +82-2-440-7894, yooe7@khu.ac.kr

Received 12 April 2011       Revised 2 June 2011       Accepted 21 June 2011

Copyright © 2011. Korean Society of Obstetrics and Gynecology

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective

To evaluate the efficacy in the anatomical and functional outcome and the safety of uterosacral vaginal vault suspension and levator myorrhaphy surgery performed during vaginal hysterectomy for pelvic organ prolapse.

Methods

A retrospective analysis was performed on the medical records of twenty-eight patients who underwent uterosacral vaginal vault suspension and levator myorrhaphy with the vaginal hysterectomy for pelvic organ prolapse. Anatomical outcomes based on pelvic organ prolapse quantification (POP-Q) system and urinary, bowel and sexual symptoms from Korean version of short form of pelvic floor distress inventory and pelvic organ prolapse and incontinence sexual questionnaire were assessed pre- and postoperatively. They were followed up for minimum a year. The recurrence was defined as any points of POP-Q system to be stage II or greater.

Results

A significant improvement of prolapse was observed from preoperative stage of III to postoperative stage of 0. The points of Ba, C, Bp were changed from 3.7 ± 1.5, 2.5 ± 1.2, -0.1 ± 2.5 to -2.7 ± 0.4, -6.2 ± 0.9, -2.1 ± 2.3. Intra-operative complications were 2 cases of ureter injury while stitching from uterosacral vaginal vault suspension surgery. Post-operative complications were 2 cases of urinary tract infection, 3 cases of voiding dysfunction and a case of urinary incontinence. No patient required reoperation for recurrent prolapse and urinary incontinence.

Conclusion

Based on our operational result, uterosacral vaginal vault suspension and levator myorrhaphy surgery seem to provide safe and effective outcomes.

Keywords: Pelvic organ prolapsed, Reconstructive surgical procedures, Vagina

Figures and Tables

Table 1
Clinical characteristics
kjog-54-454-i001

aPatients have had any medication of diabetes, hypertension, hypercholesterolemia, hypothyroidism and osteoporosis.

bPelvic Organ Prolapse-Quantification system.

cMean±standard deviation.

Table 2
Preoperative urodynamics data
kjog-54-454-i002
Table 3
Pre- and postoperative mean score of various points of pelvic organ prolapse quantification system
kjog-54-454-i003

aAnterior vaginal wall 3 cm proximal to the hymen.

bMost distal position of the remaining upper anterior vaginal wall.

cMost distal edge of cervix or vaginal cuff scar.

dPosterior vaginal wall 3 cm proximal to the hymen.

eMost distal position of the remaining upper posterior vaginal wall.

fAll of the values are presented as mean ± standard deviation.

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