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Laparoscopic uterosacral ligament uterine suspension compared with vaginal hysterectomy with vaginal vault suspension for uterovaginal prolapse
Authors:Aparna Diwan  Charles R. Rardin  William C. Strohsnitter  Alexandra Weld  Peter Rosenblatt  Neeraj Kohli
Affiliation:(1) Department of Obstetrics and Gynecology, Brigham and Women"rsquo"s Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA;(2) Division of Urogynecology, Women and Infants Hospital, Brown University, 695 Eddy Street, Providence, RI 02905, USA;(3) Tufts-New England Medical Center, 750 Washington Street, Boston, MA 021111, USA;(4) Boston Urogynecology Associates, Mt. Auburn Hospital, Harvard Medical School, 725 Concord Avenue, Suite 3300, Cambridge, MA 02138, USA;(5) Division of Urogynecology, Brigham and Women"rsquo"s Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
Abstract:This study compares the outcomes of laparoscopic uterosacral ligament uterine suspension (LUSUS) to those of vaginal vault suspension with total vaginal hysterectomy (TVH) for the treatment of symptomatic uterovaginal prolapse. We compared the outcomes of 25 LUSUS to those of 25 TVH with vaginal vault suspension among age-matched controls. No significant complications occurred in either group. EBL and hospitalization duration were significantly less in LUSUS patients (72 cc vs. 227 cc, P < .0001 and 1.05 vs. 1.65 days, P = .002). Vault support, as measured by postoperative pelvic organ prolapse quantitation system point D in the LUSUS group and point C in the TVH group, was better for the LUSUS group (D = –9 vs. C = –7.6, P = .002). No LUSUS group patient underwent reoperation for recurrent apical prolapse as compared to three TVH patients. LUSUS is an effective treatment for appropriately selected women with uterovaginal prolapse who desire uterine preservation
Keywords:Hysterectomy  Laparoscopy  Pelvic organ prolapse  Uterine suspension  Uterovaginal prolapse
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