Outcomes of uterosacral ligaments suspension for uterovaginal prolapse native-tissue repair: Over 1000-patient single-center study

•Largest study about transvaginal USL suspension for primary prolapse repair.•Recurrence rate of 12.4% with reoperation rate for recurrence below 1%.•Functional outcomes statistically improved after surgery.•Total complication rate of 3.4% with ureteral injuries being the most frequent (2.3%). Surgi...

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Published in:European journal of obstetrics & gynecology and reproductive biology 2024-10, Vol.301, p.206-209
Main Authors: Barba, Marta, Cola, Alice, Costa, Clarissa, De Vicari, Desirèe, Amatucci, Nicola, Melocchi, Tomaso, Frigerio, Matteo
Format: Article
Language:English
Subjects:
High uterosacral ligaments
McCall culdoplasty
Pelvic organ prolapse
Pelvic surgery
Shull suspension
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Summary:•Largest study about transvaginal USL suspension for primary prolapse repair.•Recurrence rate of 12.4% with reoperation rate for recurrence below 1%.•Functional outcomes statistically improved after surgery.•Total complication rate of 3.4% with ureteral injuries being the most frequent (2.3%). Surgical repair is the mainstay of genital prolapse management. Among native-tissue apical procedures, high uterosacral ligaments suspension is considered a valid and effective option for central compartment repair. In this study, we aimed to evaluate the effectiveness, complications rate, and functional results of high USL suspension as a primary prolapse repair technique in a large cohort of patients. Patients who underwent vaginal hysterectomy followed by high uterosacral ligaments suspension for POP between January 2008 and December 2020 were retrospectively analyzed. Questionnaires and clinical interviews were preoperatively performed to assess symptoms and severity of urinary, bowel, and sexual dysfunctions. After surgical procedure, diagnostic cystoscopy was performed to evaluate ureteral patency. Postoperative data, objective, and subjective cure rate were then noted at the follow-up evaluation. A total of 1099 patients underwent high uterosacral ligaments suspension. The total complication rate was 3.4 % and recurrence in any of the vaginal compartments was 12.4 %. Reoperation for symptomatic prolapse recurrence or pessary treatment was required in 9 women (0.9 %). In the evaluation of postoperative questionnaires, functional outcomes analysis revealed a significant improvement (p 
ISSN:0301-2115
1872-7654
1872-7654
DOI:10.1016/j.ejogrb.2024.08.020