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Cited by 102Pelvic floor disorders treatmentsUterine Myomas and TreatmentsUreteral procedures and complications

Anatomic and functional assessment and risk factors of recurrent prolapse after vaginal sacrospinous fixation

Nieminen, Kari, Huhtala, Heini, Heinonen, Pentti K.·2003·Acta Obstetricia et Gynecologica Scandinavica
DOI 10.1034/j.1600-0412.2003.00137.x
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Abstract

Background. To identify risk factors in recurrence and to evaluate anatomic and functional results of vaginal sacrospinous ligament fixation and pelvic floor reconstruction for genital prolapse. Methods. One hundred and thirty‐eight women underwent surgery for uterovaginal or vault prolapse. Follow‐up data were available for 122 cases; 83% were examined and others were interviewed by telephone. The median (range) follow‐up was 24 (1–141) months. Cox regression was used to identify risk factors associated with recurrence; uni‐ and multivariate regression was used to identify risk factors underlying postoperative infections because infections were found to be a risk factor of recurrence. Recurrence‐free survival was estimated using the Kaplan–Meier method. Results. Seven (5%) patients suffered severe cardiopulmonary complications including one postoperative death due to a pulmonary embolism. Twenty‐six (21%) patients suffered a recurrence, 14 with cystocele. Ten patients with recurrence were symptomatic and six underwent a re‐operation. The Cox regression model showed that vaginal cuff infection raised the odds ratio (OR) for recurrence to 6.13 [confidence interval (CI) 1.80–20.83] and urinary tract infection to 3.65 (CI 1.40–9.47). In both uni‐ and multivariate analysis, lack of intravenous antibiotic prophylaxis, age less than 73 years and vaginal ulcerations were statistically significant risk factors for postoperative infection. Eleven (33%) out of 33 sexually active women reported improvement and three (9%) complained of dyspareunia. Conclusions. Transvaginal sacrospinous ligament fixation with pelvic floor repair is an effective means of correcting both vault prolapse and uterine procidentia. Women who wish to preserve coital function will also benefit from this operation. Postoperative infection is an independent and most important individual risk factor underlying recurrence. Prophylactic antibiotics seem to be effective in reducing the rate of postoperative infections.

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Authors
Nieminen, K., Huhtala, H., & Heinonen, P. K.
Affiliations
Tampere University Hospital (FI)
ORCID
Venue
Acta Obstetricia et Gynecologica Scandinavica
Publisher
Wiley
Published
2003-05
Volume
82
Issue
5
Pages
471-478
ISSN
  • 0001-6349 (ISSN-L)
  • 1600-0412
DOI
10.1034/j.1600-0412.2003.00137.x
OpenAlex
W2119233927
Cited by
102
References
24
Citations by year
2026: 2 · 2024: 2 · 2023: 2 · 2022: 2 · 2021: 3 · 2020: 3 · 2019: 5 · 2018: 4 · 2017: 10 · 2016: 5 · 2015: 2 · 2014: 3 · 2013: 1 · 2012: 3
FWCI
2.71
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 11 d)
Locations
  • Acta Obstetricia Et Gynecologica Scandinavica (publishedVersion)
  • PubMed (publishedVersion)
Funders
Tays
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 floor reconstruction, uterovaginal prolapse, vaginal vault prolapse, prolapse recurrence, risk factors, postoperative infection, urinary tract infection, dyspareunia, cystocele, postoperative complications
MeSH terms
Activities of Daily Living, Aged, Aged, 80 and over, Broad Ligament, Female, Finland, Humans, Middle Aged, Pulmonary Embolism, Quality of Life, Recurrence, Retrospective Studies, Risk Factors, Sacrococcygeal Region, Gynecologic Surgical Procedures, Time Factors, Urinary Tract Infections, Uterine Prolapse, Vagina, Multivariate Analysis, Proportional Hazards Models, Pelvic Floor, Antibiotic Prophylaxis

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