Medium-Term Risk of Recurrent Pelvic Organ Prolapse within 2-Year Follow-Up after Laparoscopic Sacrocolpopexy.

IF 1.4 Q3 OBSTETRICS & GYNECOLOGY
Hirotaka Sato, Shota Otsuka, Hirokazu Abe, Tomoaki Miyagawa
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Abstract

Objective: The present study was performed to determine the risk of recurrent pelvic organ prolapse (POP) within 2 years after laparoscopic sacrocolpopexy (LSC) in patients with uterovaginal prolapse.

Materials and methods: A retrospective comparative study was performed in a population of 204 patients over a 2-year follow-up period following LSC with concomitant supracervical hysterectomy or uterine preservation at a single urological clinic between 2015 and 2019. The primary outcome was surgical failure following LSC in cases of POP, focusing on failures occurring before the 2ndyear of follow-up. Logistic regression analysis was used to determine the odds ratios (ORs) for surgical failure.

Results: The primary outcome, surgical failure in cases of POP, occurred 2 years after the initial surgery in 19 of the 204 patients (9.3%) (95% confidence interval [CI], 5.7% - 14.2%). Surgical failure was most common in the anterior compartment (n = 10, 4.9%), and further surgery was performed in seven of the patients with surgical failure (3.4%). The poor primary outcome was predicted by lysis of adhesions (OR, 7.5, 95% CI, 1.6-33.8, P = 0.008) and preoperative POP stage IV (OR, 3.5; 95% CI, 1.1-10.8, P = 0.03) on multivariable logistic regression analysis.

Conclusion: The overall rate of surgical failure following LSC in our cohort was 9.3% over the 2-year follow-up period after surgery, and preoperative prolapse stage IV was associated with a higher risk of recurrence.

Abstract Image

腹腔镜骶骶固定术术后2年随访中盆腔器官脱垂复发的中期风险。
目的:本研究旨在确定子宫阴道脱垂患者行腹腔镜骶colpop固定术(LSC)后2年内复发盆腔器官脱垂(POP)的风险。材料和方法:2015年至2019年,在一家泌尿科诊所,对LSC合并宫颈上子宫切除术或子宫保留术后204例患者进行了为期2年的回顾性比较研究。主要结果是POP病例LSC后手术失败,重点是随访2年之前发生的失败。采用Logistic回归分析确定手术失败的优势比(ORs)。结果:204例患者中有19例(9.3%)在首次手术后2年出现手术失败(95%可信区间[CI], 5.7% - 14.2%)。手术失败在前房室最常见(n = 10, 4.9%),手术失败的患者中有7例(3.4%)进行了进一步的手术。不良的主要预后预测为粘连溶解(OR, 7.5, 95% CI, 1.6-33.8, P = 0.008)和术前POP IV期(OR, 3.5;多变量logistic回归分析95% CI, 1.1 ~ 10.8, P = 0.03)。结论:在我们的队列中,LSC术后2年随访期间的总体手术失败率为9.3%,术前IV期脱垂与较高的复发风险相关。
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来源期刊
CiteScore
2.00
自引率
16.70%
发文量
98
审稿时长
52 weeks
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