Outcomes of Transvaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) for Uterosacral Ligament Suspension in Apical Compartment Prolapse: A Systematic Review.
Qi Wang, Xiaoxiang Jiang, Stefano Manodoro, Chaoqin Lin
{"title":"Outcomes of Transvaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) for Uterosacral Ligament Suspension in Apical Compartment Prolapse: A Systematic Review.","authors":"Qi Wang, Xiaoxiang Jiang, Stefano Manodoro, Chaoqin Lin","doi":"10.1007/s00192-025-06195-x","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>This systematic review is aimed at assessing the efficacy and safety of transvaginal natural orifice transluminal endoscopic surgery-uterosacral ligament suspension (vNOTES-USLS) based on current evidence.</p><p><strong>Methods: </strong>A comprehensive search of PubMed and Web of Science was conducted for studies published up to 31 December 2024. Original studies on vNOTES-USLS were included, whereas reviews, abstracts, and publications not in the English language were excluded. No restrictions were placed on sample size or publication date.</p><p><strong>Results: </strong>Nine studies with 336 patients met the criteria, including 1 randomized controlled trial, 3 prospective, and 5 retrospective studies. Operative time ranged from 17.4 ± 6.4 to 29.7 ± 8.2 minutes. Hemoglobin reduction varied between 1.12 ± 0.83 and 1.80 ± 1.57 g/dl. Hospital stays ranged from 1.0 ± 0.5 to 3.7 ± 1.1 days. Intraoperative complications occurred in 2.1% (7 out of 336), with bladder injury being the most common (3 cases). One patient required conversion to vaginal USLS, but no laparotomy conversions were reported. Ureteral kinking occurred in 1 case (0.3%) and was resolved intraoperatively. Postoperative complications were reported in 7.4% (25 out of 336), with urinary tract infection being the most frequent (10 cases). Over 1-37 months of follow-up, 1 patient required reoperation for anterior prolapse recurrence.</p><p><strong>Conclusion: </strong>vNOTES-USLS appears to be a promising option for apical prolapse, with favorable short-term outcomes. However, small sample sizes, short follow-ups, and study design variations limit current evidence. Larger prospective studies with longer follow-ups and direct comparisons with established procedures are needed to assess long-term safety and effectiveness.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8000,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Urogynecology Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00192-025-06195-x","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction and hypothesis: This systematic review is aimed at assessing the efficacy and safety of transvaginal natural orifice transluminal endoscopic surgery-uterosacral ligament suspension (vNOTES-USLS) based on current evidence.
Methods: A comprehensive search of PubMed and Web of Science was conducted for studies published up to 31 December 2024. Original studies on vNOTES-USLS were included, whereas reviews, abstracts, and publications not in the English language were excluded. No restrictions were placed on sample size or publication date.
Results: Nine studies with 336 patients met the criteria, including 1 randomized controlled trial, 3 prospective, and 5 retrospective studies. Operative time ranged from 17.4 ± 6.4 to 29.7 ± 8.2 minutes. Hemoglobin reduction varied between 1.12 ± 0.83 and 1.80 ± 1.57 g/dl. Hospital stays ranged from 1.0 ± 0.5 to 3.7 ± 1.1 days. Intraoperative complications occurred in 2.1% (7 out of 336), with bladder injury being the most common (3 cases). One patient required conversion to vaginal USLS, but no laparotomy conversions were reported. Ureteral kinking occurred in 1 case (0.3%) and was resolved intraoperatively. Postoperative complications were reported in 7.4% (25 out of 336), with urinary tract infection being the most frequent (10 cases). Over 1-37 months of follow-up, 1 patient required reoperation for anterior prolapse recurrence.
Conclusion: vNOTES-USLS appears to be a promising option for apical prolapse, with favorable short-term outcomes. However, small sample sizes, short follow-ups, and study design variations limit current evidence. Larger prospective studies with longer follow-ups and direct comparisons with established procedures are needed to assess long-term safety and effectiveness.
期刊介绍：
The International Urogynecology Journal is the official journal of the International Urogynecological Association (IUGA).The International Urogynecology Journal has evolved in response to a perceived need amongst the clinicians, scientists, and researchers active in the field of urogynecology and pelvic floor disorders. Gynecologists, urologists, physiotherapists, nurses and basic scientists require regular means of communication within this field of pelvic floor dysfunction to express new ideas and research, and to review clinical practice in the diagnosis and treatment of women with disorders of the pelvic floor. This Journal has adopted the peer review process for all original contributions and will maintain high standards with regard to the research published therein. The clinical approach to urogynecology and pelvic floor disorders will be emphasized with each issue containing clinically relevant material that will be immediately applicable for clinical medicine. This publication covers all aspects of the field in an interdisciplinary fashion
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
