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Cited by 52Pelvic floor disorders treatmentsUterine Myomas and TreatmentsUreteral procedures and complications

Outcomes of Transvaginal High Uterosacral Ligaments Suspension: Over 500-Patient Single-Center Study

Milani, Rodolfo, Frigerio, Matteo, Cola, Alice, Beretta, Carlo, Spelzini, Federico, Manodoro, Stefano·2018·Female Pelvic Medicine & Reconstructive Surgery
DOI 10.1097/spv.0000000000000403
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Abstract

Background: Uterosacral ligament (USL) suspension is a safe and effective procedure in terms of anatomical, functional, and subjective outcomes for primary surgical treatment of prolapse. Objectives: There has been a renewed interest toward native tissue prolapse repair by vaginal route because of low cost and lack of mesh-related complications. Uterosacral ligaments are considered safe, effective, and durable as suspending structures for primary surgical repair of the apical compartment. Our aim was to evaluate complications, anatomical, functional and subjective outcomes of high USL suspension for primary prolapse repair. Methods: Data of patients who underwent vaginal hysterectomy followed by high USL suspension for pelvic organ prolapse were retrospectively analyzed. Operative data, as well as complications, were recorded. Anatomical recurrence was defined as descent of any compartment stage II or greater according to the Pelvic Organ Prolapse Quantification system. Functional outcomes focused on urinary, bowel, and sexual dysfunctions. International Consultation on Incontinence Questionnaire–Urinary Incontinence Short Form, Wexner, and Patient Global Impression of Improvement questionnaires were collected. Results: Data of 533 women were analyzed. Mean follow-up was 32 (SD, 19) months (dropout rate, 2.6%). Most frequent complication was ureteral kinking (2.6%). Total recurrence rate was 13.7%, with anterior compartment being the most frequent (9.4%), whereas reoperation for symptomatic prolapse recurrence was required in only 1% of patients. Improvement of urinary incontinence, voiding dysfunction, constipation, and dyspareunia was observed. Overall subjective satisfaction was high (Patient Global Impression of Improvement score, 1.3), ranging from “much improved” to “very much improved.” Conclusions: Uterosacral ligament suspension is a safe and effective procedure in primary surgical treatment of pelvic organ prolapse. Anatomical, functional, and subjective outcomes were very satisfactory, and reoperation rate for recurrence was only 1%.

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Authors
Milani, R., Frigerio, M., Cola, A., Beretta, C., Spelzini, F., & Manodoro, S.
Affiliations
Azienda Ospedaliera San Gerardo (IT)
Corresponding author
  • Milani, Rodolfo
  • Frigerio, Matteo
  • Cola, Alice
  • Beretta, Carlo
  • Spelzini, Federico
ORCID
Venue
Female Pelvic Medicine & Reconstructive Surgery
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2018-01
Volume
24
Issue
1
Pages
39-42
ISSN
2151-8378 (ISSN-L)
DOI
10.1097/spv.0000000000000403
OpenAlex
W2589775503
Cited by
52
References
25
Citations by year
2026: 1 · 2025: 3 · 2024: 6 · 2023: 5 · 2022: 9 · 2021: 3 · 2020: 8 · 2019: 5 · 2018: 5 · 2017: 7
FWCI
5.98
Type
journal article
Language
en
Open access
closed
Locations
  • Urogynecology (publishedVersion)
  • PubMed (publishedVersion)
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
uterosacral ligament suspension, pelvic organ prolapse, vaginal hysterectomy, prolapse recurrence, ureteral kinking, urinary incontinence, voiding dysfunction, constipation, dyspareunia, patient satisfaction, surgical complications
MeSH terms
Aged, Female, Humans, Hysterectomy, Ligaments, Middle Aged, Surveys and Questionnaires, Recurrence, Urinary Incontinence, Treatment Outcome, Patient Satisfaction, Plastic Surgery Procedures, Pelvic Organ Prolapse

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