Recurrent apical prolapse after high uterosacral ligament suspension - in a heterogenous cohort characterised by a high prevalence of previous pelvic operations
Open accessAbstract
BACKGROUND: The apical prolapse is probably the most complex form of pelvic organ prolapse (POP). Adequate apical support is essential in the treatment of POP, as it contributes to the support in all vaginal compartments. This study aimed to evaluate the rate of symptomatic recurrent apical prolapse after high uterosacral ligament suspension (HUSLS), in a cohort of women characterised by a high prevalence of previous pelvic operations and a significant degree of prolapse. METHODS: This is a retrospective chart review of 95 women who underwent HUSLS for symptomatic apical prolapse from 2002 to 2009 at Aarhus University Hospital, Denmark. Of these women, 97% attended a six-month clinical control. Recurrence was defined as symptomatic vaginal vault prolapse stage 2 or more (according to the International Continence Society (ICS) quantification system). Medical charts were reviewed for a mean period of 7.2 years. Any new contacts due to prolapse were noted. RESULTS: Before the operation, 73% of the women were hysterectomised, and 52% had previous prolapse surgery. Stage 2 apical prolapse was reported in 71% of the women, whereas 26% had stage 3 or 4. At six-month follow-up, 19% of the women had recurrent symptomatic apical prolapse, and 9% of the women had symptomatic recurrent prolapse in other compartments 6 months after operation. In all, 35% of the women had a renewed prolapse operation during the long-term follow-up period. Perioperative adverse events were seen in 7%. Two women were re-operated due to postoperative complications. CONCLUSIONS: This retrospective study of 95 women with a significant degree of prolapse and a high prevalence of previous pelvic operations demonstrates that the rate of recurrent prolapse associated with HUSLS might be higher than originally described. In conclusion, HUSLS may not be the optimal first choice of operation in this group of patients.
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The recurrence rate is comparable to that of other techniques of apical compartment suspension.
“The recurrence rate is comparable to that of other techniques of apical compartment suspension [27,28].”
From Recurrence Rate and Risk Factors for Apical Prolapse After Sacrospinous Ligament Fixation: A Prospective Cohort Study (2026) · cites this paper as [28]
The Results report 19% symptomatic apical recurrence after high uterosacral ligament suspension. The Discussion mentions studies of other suspension techniques, but does not establish that their recurrence rates are comparable; it says comparisons are difficult because the studies are heterogeneous. No page numbers are available in our copy. (LLM, conf=0.82)
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References 22 · Cited by 13
- Authors
- Pedersen, K. D., Storkholm, M. H., Bek, K. M., Glavind-Kristensen, M., & Greisen, S.
- Affiliations
- Aarhus University Hospital (DK)
- Regional Hospital Horsens (DK)
- Corresponding author
- Pedersen, Katrine Dahl
- Venue
- BMC Women's Health
- Published
- 2019-07-12
- Volume
- 19
- Issue
- 1
- Pages
- 96-96
- ISSN
- 1472-6874 (ISSN-L)
- PMC
- PMC6626360
- OpenAlex
- W2958462142
- Cited by
- 13
- References
- 22
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 1 · 2023: 3 · 2022: 4 · 2021: 1
- FWCI
- 0.95
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Women s Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Scopus (Elsevier) (submittedVersion, other-oa)
- 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, vaginal vault prolapse, previous pelvic surgery, hysterectomy, apical support, long-term outcomes, reoperation, perioperative complications
- MeSH terms
- Aged, Denmark, Female, Humans, Ligaments, Middle Aged, Postoperative Period, Recurrence, Retrospective Studies, Sacrum, Gynecologic Surgical Procedures, Uterus, Vagina, Prevalence, Treatment Outcome, Pelvic Organ Prolapse
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