A randomised controlled trial comparing abdominal and vaginal prolapse surgery: effects on urogenital function
Abstract
Objective To compare the effects of vaginal hysterectomy (combined with anterior and/or posterior colporraphy) and abdominal sacro‐colpopexy (with preservation of the uterus) on urogenital function. Design Randomised trial. Setting Three teaching hospitals in The Netherlands. Population Eighty‐two patients undergoing surgical correction of uterine prolapse stages II–IV. Methods Participating patients completed the urogenital distress inventory (UDI), before and at six weeks, six months and one year after surgery, to measure discomfort of prolapse and micturition symptoms. Domain scores of the UDI (ranging from 0 to 100, higher scores indicating more discomfort) were compared between groups at all time points. Findings at pelvic examination, number of doctor visits within the first year after surgery because of pelvic floor symptoms and performed or planned surgery of recurrent genital prolapse were also compared. Main outcome measure Domain scores of the UDI at one year after surgery. Results At one year after surgery, scores on the discomfort/pain domain (mean difference 7.1, 95% confidence interval [CI] 1.1–13.2), overactive bladder domain (mean difference 8.7, 95% CI 0.5–16.9) and obstructive micturition domain (mean difference 10.3, 95% CI 0.6–20.1) of the UDI were significantly higher in the abdominal group than in the vaginal group. Findings at pelvic examination were similar in both groups. Doctor visits because of pelvic floor symptoms were more frequent in the abdominal group than in the vaginal group. Re‐operation was performed or planned in 9 of the 41 patients who underwent abdominal surgery and in 1 of the 41 patients who underwent vaginal surgery (odds ratio [OR] = 11.2, 95% CI 1.4–90.0). Conclusions Our findings suggest that vaginal hysterectomy with anterior and/or posterior colporraphy is preferable to abdominal sacro‐colpopexy with preservation of the uterus as surgical correction in patients with uterine prolapse stages II–IV.
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A multicentre trial in the Netherlands (N = 82) compared open sacrohysteropexy with VH and found comparable rates of subjective prolapse symptom scores but higher reoperation and medical consultation for prolapse after hysteropexy compared with VH at 12 months.
“A multicentre trial in the Netherlands (N = 82) compared open sacrohysteropexy with VH, and found comparable rates of subjective prolapse symptom scores but higher reoperation and medical consultation for prolapse after hysteropexy compared with VH at 12 months [13].”
From Laparoscopic sacrohysteropexy versus vaginal hysterectomy and apical suspension: 7-year follow-up of a randomized controlled trial (2022) · cites this paper as [13]
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- Authors
- Roovers, J. W. R., van der Vaart, C. H., van der Bom, J. G., Schagen van Leeuwen, J. H., Scholten, P. C., & Heintz, A. P. M.
- Affiliations
- University Medical Center Utrecht (NL)
- Diakonessenhuis hospital (NL)
- Corresponding author
- Roovers, Jan‐Paul W.R.
- Venue
- BJOG: An International Journal of Obstetrics & Gynaecology
- Publisher
- Wiley
- Published
- 2003-12-15
- Volume
- 111
- Issue
- 1
- Pages
- 50-56
- ISSN
- 0306-5456 (ISSN-L)
- 1470-0328
- 1471-0528
- OpenAlex
- W2104857835
- Cited by
- 152
- References
- 1
- Citations by year
- 2026: 4 · 2025: 1 · 2024: 4 · 2023: 4 · 2022: 6 · 2021: 11 · 2020: 6 · 2019: 3 · 2018: 9 · 2017: 11 · 2016: 13 · 2015: 2 · 2014: 4 · 2013: 10 · 2012: 8
- FWCI
- 3.09
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- BJOG An International Journal of Obstetrics & Gynaecology (publishedVersion)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Topics
- Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
- Health Sciences › Medicine › Obstetrics and Gynecology › Uterine Myomas and Treatments
- Health Sciences › Medicine › Urology › Urinary Bladder and Prostate Research
- Keywords
- uterine prolapse, vaginal hysterectomy, sacrocolpopexy, urogenital function, Urogenital Distress Inventory, overactive bladder, micturition symptoms, pelvic floor symptoms, reoperation, pelvic organ prolapse surgery
- MeSH terms
- Female, Follow-Up Studies, Humans, Hysterectomy, Vaginal, Middle Aged, Postoperative Pain, Postoperative Complications, Recurrence, Reoperation, Suture Techniques, Urinary Incontinence, Stress, Uterine Prolapse, Treatment Outcome, Colpotomy
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