Functional outcome after pelvic floor reconstructive surgery with or without concomitant hysterectomy
Abstract
Purpose When counseling patients about surgical alternatives for pelvic organ prolapse (POP) repair, numerous things have to be considered. Uterine preservation vs. hysterectomy is one relevant issue. Hysterectomy has been traditionally performed for POP, but its benefit regarding outcome has never been proven. Furthermore, a growing number of women ask for uterine preservation.Methods In this retrospective cohort study, 384 patients who had undergone surgery for POP between 2000 and 2012 at Freiburg University Medical Center were included. Using a standardized questionnaire, further surgeries, urinary incontinence, recurrent POP, pessary use, and satisfaction with the surgical outcome were evaluated. The functional results after uterine preservation vs. concomitant hysterectomy were compared using t test.Results 196 (51.04%) women were available for follow-up and agreed to participate (n = 122 with hysterectomy, n = 72 with uterine-preserving surgery, respectively). After a mean follow-up time of 67 months, vaginal bulge symptoms and urinary incontinence did not differ between treatment groups. We observed higher success rates and satisfaction scores in the uterine-preserving group. Regarding satisfaction with surgery and whether the patients thought it had been successful, we observed a trend toward better results in the uterine-preserving group (mean satisfaction score: 8.45 ± 2.15 vs. 7.76 ± 2.91, range 0-10, p = 0.061; success: 91.4 vs. 81.7 %, p = 0.087).Conclusions There was no difference with regard to functional outcome between patients with or without concomitant hysterectomy. Satisfaction with the operation was slightly higher after uterus preserving surgery. Therefore, uterine-preserving surgery is a valuable option unless there are contraindications.
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These findings contrast with previous observational studies that reported higher mesh exposure rates when total hysterectomy or vaginal mesh procedures were included.
“These findings contrast with previous observational studies that reported higher mesh exposure rates when total hysterectomy or vaginal mesh procedures were included [15–24, 29].”
From Perioperative complications of laparoscopic sacrohysteropexy versus sacrocolpopexy with subtotal hysterectomy for pelvic organ prolapse (2026) · cites this paper as [16]
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- Authors
- Farthmann, J., Watermann, D., Erbes, T., Roth, K., Nanovska, P., Gitsch, G., & Gabriel, B.
- Affiliations
- University of Freiburg (DE)
- Evangelisches Diakoniekrankenhaus (DE)
- Corresponding author
- Farthmann, Juliane
- Venue
- Archives of Gynecology and Obstetrics
- Published
- 2014-09-09
- Volume
- 291
- Issue
- 3
- Pages
- 573-577
- ISSN
- 0003-9128 (ISSN-L)
- 0932-0067
- 1432-0711
- OpenAlex
- W2082378662
- Cited by
- 25
- References
- 19
- Citations by year
- 2026: 1 · 2024: 1 · 2022: 1 · 2021: 1 · 2020: 1 · 2019: 7 · 2018: 5 · 2017: 4 · 2016: 3 · 2015: 1
- FWCI
- 2.21
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Archives of Gynecology and Obstetrics (publishedVersion)
- PubMed (publishedVersion)
- FreiDok plus (Universitätsbibliothek Freiburg) (submittedVersion)
- Topics
- Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
- Health Sciences › Medicine › Obstetrics and Gynecology › Uterine Myomas and Treatments
- Health Sciences › Medicine › Obstetrics and Gynecology › Ureteral procedures and complications
- Keywords
- pelvic organ prolapse, pelvic floor reconstruction, hysterectomy, uterine preservation, concomitant hysterectomy, functional outcome, patient satisfaction, urinary incontinence, recurrent pelvic organ prolapse
- MeSH terms
- Aged, Aged, 80 and over, Female, Humans, Hysterectomy, Middle Aged, Pessaries, Quality of Life, Surveys and Questionnaires, Retrospective Studies, Urinary Incontinence, Uterus, Treatment Outcome, Pelvic Floor, Plastic Surgery Procedures, Pelvic Organ Prolapse
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