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

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• 作者：Zhixing Sun^a ; ^b ; Lan Zhu^a ; ^{zhu_julie@sina.com" class="auth_mail" title="E-mail the corresponding author} ; Huiying Hu^a ; Jinghe Lang^a ; Honghui Shi^a ; Xiaoming Gong^a
• 关键词：Clinical outcome ; High uterosacral ligament suspension ; Laparoscopy ; Severe ; Uterine prolapse
• 刊名：International Journal of Gynecology and Obstetrics
• 出版年：2016
• 出版时间：February 2016
• 年：2016
• 卷：132
• 期：2
• 页码：224-228
• 全文大小：434 K

文摘

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.