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Anterior Wall Success at 1 Year After Vaginal Uterosacral Ligament Suspension and Sacral Colpopexy

Bastawros, Dina A., MD*; Tarr, Megan E., MD, MS*; Templin, Megan A., MPH, MS; Stepp, Kevin J., MD*; Taylor, G. Bernard, MD*; Myers, Erinn M., MD*

Female Pelvic Medicine & Reconstructive Surgery: November 2, 2018 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/SPV.0000000000000647
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Objectives The primary objective was to evaluate 1-year anterior wall anatomic success rates for vaginal uterosacral ligament suspension (USLS) and minimally invasive sacral colpopexy (SCP) using delayed-absorbable suture. Secondary objectives included assessment of apical success, mesh or suture exposure, and postoperative quality of life (QoL) measures 12 months after surgery.

Methods This was a retrospective cohort study including women who underwent a hysterectomy with concomitant USLS or SCP with delayed-absorbable suture from January 2011 to December 2015 with 1-year follow-up. Successful anterior vaginal wall support was defined as Ba of less than 0. Successful apical support was defined as no apical descent (point C) greater than one half of the total vaginal length. In addition, 1-year QoL questionnaires were measured postoperatively.

Results A total of 282 women were identified. Sixty-two women (31 vaginal USLS and 31 SCP) met inclusion criteria. Demographics were similar between groups except for a higher body mass index in the USLS group (27.5 ± 5.6 kg/m2 vs 24.1 ± 3.3 kg/m2, P < 0.05). Preoperative POP-Q was mostly stage II and III. At 1-year, anatomic success rates for the anterior compartment were 66.7% versus 90.3% for USLS and SCP groups, respectively (P = 0.02). There was no significant difference in apical success (P = 1.00) or QoL scores between groups at 1 year.

Conclusions Anatomic success rates at 1 year using delayed-absorbable suture were better for SCP when using the anterior wall as a measure of success, but there were no significant differences in apical success rates, mesh or suture exposure, and QoL measures between groups.

From the *Women's Center for Pelvic Health, Carolinas Medical Center; and

Center for Outcomes Research and Evaluation (CORE), Charlotte, NC.

Correspondence: Dina Bastawros, MD, 2001 Vail Ave, Suite 360, Charlotte, NC 28207. E-mail: dina.bastawros@carolinashealthcare.org.

The authors have declared they have no conflicts of interest.

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