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Bilateral extraperitoneal uterosacral vaginal vault suspension: a 2-year follow-up longitudinal case series of 123 patients

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Abstract

Introduction and hypothesis

The objective of this study is to assess anatomical and functional results of the extraperitoneal uterosacral ligament suspension (USL) in women with post-hysterectomy vaginal vault prolapse.

Methods

One hundred and twenty-three consecutive women were included. Concurrent procedures were anterior colporraphy with fascial repair (20%) and mesh reinforcement (49%), posterior colporraphy with fascial repair (38%) and mesh reinforcement (56%) and a sling procedure (29%). Women were assessed using Baden and Walker and pelvic organ prolapse quantification classification pre- and post-operatively.

Results

One hundred and ten patients (89%) were available for follow-up. Mean follow-up was 2 years. Objective success rate regarding the vaginal cuff is 95.4%. Global anatomical success rate was 85.5%. Urinary, coital and bowel symptoms were improved following surgery. Mesh exposure rate was 19.3%, with all cases managed conservatively or with minor interventions.

Conclusion

Bilateral extraperitoneal USL is an effective operation to restore apical support with low morbidity, which avoids potential risks associated with opening the peritoneal cavity.

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Acknowledgements

We want to thank Dr. Bruno Aublet Cuvelier (Medical Information management Unit, University Hospital Clermont-Ferrand, France) for his contribution in the statistical analysis.

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None.

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Authors and Affiliations

  1. Urogynaecology Department, Mercy Hospital for Women, Melbourne, Australia

    Brigitte Fatton, Peter L. Dwyer, Chahin Achtari & P. K. Tan

  2. Urogynaecology Department, University Hospital of Clermont-Ferrand, Clermont Ferrand, France

    Brigitte Fatton

  3. Urogynecology Department, Maternité Hôtel Dieu, Boulevard Léon Malfreyt, 63058, Clermont Ferrand Cedex 1, France

    Brigitte Fatton

Authors
  1. Brigitte Fatton
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  2. Peter L. Dwyer
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  3. Chahin Achtari
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  4. P. K. Tan
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Correspondence to Brigitte Fatton.

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Fatton, B., Dwyer, P.L., Achtari, C. et al. Bilateral extraperitoneal uterosacral vaginal vault suspension: a 2-year follow-up longitudinal case series of 123 patients. Int Urogynecol J 20, 427–434 (2009). https://doi.org/10.1007/s00192-008-0791-8

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  • DOI: https://doi.org/10.1007/s00192-008-0791-8

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