• About Us
    • Contact Us
    • Login
    • ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • #GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
About Us Contact Us Login ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • 0 CME Hours
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • #GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
#Grand Rounds

What is the Best Approach to Repair Vaginal Vault Prolapse following Hysterectomy?

image_pdfFavoriteLoadingFavorite

BACKGROUND AND PURPOSE:

  • There is lack of high level evidence regarding best approach to repair vaginal vault prolapse following hysterectomy
  • Malika et al. (Female Pelvic Medicine & Reconstructive Surgery, 2017) compared vaginal, open and robotic surgical approaches for the management of posthysterectomy vaginal vault prolapse

METHODS:

  • Questionnaire-based retrospective study
  • Patients who had undergone surgery for posthysterectomy apical vaginal prolapse
  • Three techniques compared
    • Mayo-McCall culdoplasty (MMC)
    • Open abdominal sacrocolpopexy (ASC)
    • Robotic sacrocolpopexy (RSC)
  • Baseline characteristics and perioperative outcomes were abstracted from electronic health records
  • Validated questionnaires were used to do cross sectional data for current pelvic floor symptoms
  • Survival free of retreatment was estimated with Kaplan-Meier method

RESULTS:

  • 337 people completed at least a validated or abbreviated questionnaire
  • Overall, there were no differences when comparing long-term posttreatment symptoms and quality of life among the 3 groups but some domain differences
  • Urogenital Distress: MMC group had a greater median score (more distress) than patients who had undergone ASC (20.8 vs 8.3, P=0.02)
  • Colorectal-Anal Distress: MMC had a greater median Colorectal-Anal Distress score (18.8 vs 12.5, P=0.04) compared to RSC
    • Otherwise, there were no significant differences in the long-term posttreatment symptoms and quality of life between these 2 procedures
  • There was no significant difference in 5-year survival free of retreatment for MMC (94.0%) versus RSC (95.5%) and ASC (94.8%) versus RSC (92.1%)
  • However, patients who had MMC were more likely to have retreatment than patients who had ASC during the first 10 years
    • 10-year survival free of retreatment: 81.1% vs 95.4%; hazard ratio, 3.68 (95% CI 1.51–8.98)
  • Authors recommend long-term follow up under the AUGS Registry

CONCLUSION:

  • Symptom relief and retreatment rates were comparable between procedures
  • ASC has greater durability compared to MMC

Learn More – Primary Sources:

Symptom Relief and Retreatment After Vaginal, Open, or Robotic Surgery for Apical Vaginal Prolapse

image_pdfFavoriteLoadingFavorite

< Previous
All #Grand Rounds Posts
Next >

Related ObG Topics:

Comparing the Use of Mesh Against Standard Repair for Prolapse
Practical info for your gynecology practice
Cystourethroscopy – Did I Cut, Twist, Suture, Burn, or Make a Hole in It?
Recognition, Evaluation and Treatment of Vaginal Cuff Separation
Preemptive Analgesia to Control Postop Hysterectomy Pain: The SGS Clinical Guidelines

Sections

  • COVID-19
  • Alerts
  • OB
  • GYN
    • GYN
    • Sexual Health
  • 2T US Atlas
  • The Genome
  • Primary Care
  • Your Practice
  • #Grand Rounds
  • My Bookshelf
  • Now@ObG
  • Media

ObG Library

  • Hysteroscopy
  • Fertility
  • Site Map/
  • © ObG Project/
  • Terms and Conditions/
  • Privacy/
  • Contact Us/
© ObG Project
SSL Certificate


  • Already an ObGFirst Member?
    Welcome back

    Log In

    Want to sign up?
    Get guideline notifications
    CME Included

    Sign Up

Get Guideline Alerts Direct to Your Phone
Try ObGFirst Free!

Sign In

Lost your password?

Sign Up for ObGFirst and Stay Ahead

  • - Professional guideline notifications
  • - Daily summary of a clinically relevant
    research paper
  • - Includes 1 hour of CME every month

ObGFirst Free Trial

Log In to ObG First

Please log in to access OBGFirst and the 2T Ultrasound Atlas

Password Trouble?

Sign Up for ObGFirst

  • - Access 2T US Atlas
  • - Guideline notifications
  • - Daily research paper summaries
  • - And lots more!

ObG First Free Trial

Media - Internet

Computer System Requirements

OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Jointly provided by

NOT ENOUGH CME HOURS

It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan

Subscribe

JOIN OBGFIRST AND GET CME/CE CREDITS

One of the benefits of an ObGFirst subscription is the ability to earn CME/CE credits from the ObG entries you read. Tap the button to learn more about ObGFirst

Learn More
Leaving ObG Website

You are now leaving the ObG website and on your way to PRIORITY at UCSF, an independent website. Therefore, we are not responsible for the content or availability of this site