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Anatomic and functional outcomes of sacrocolpopexy with or without posterior colporrhaphy

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Abstract

Introduction and hypothesis

The optimal surgery for combined apical and posterior vaginal prolapse is not well defined. Our objective was to examine the anatomic and functional outcomes following sacrocolpopexy (SCP) with or without posterior colporrhaphy (PC).

Methods

We retrospectively evaluated 258 women who underwent abdominal (n = 62) or laparoscopic (n = 196) SCP with or without PC. Preoperative anatomic support and standardized bowel symptoms were compared to 6-week and 1-year postoperative values, using Student’s t test and Wilcoxon rank sum test, respectively.

Results

Six-week follow-up data were available for 235 of 258 (91.1 %) women, while 125 of 258 (48.4 %) women had 1-year anatomic and functional outcomes recorded. While the SCP + PC group had worse posterior descent and bowel function preoperatively, there were no significant differences in postoperative anatomic support or symptoms. Long-term pelvic floor function was similar, as measured by three validated instruments. Reduction in the proportion of women with splinting was greater in the SCP + PC group.

Conclusions

SCP with or without PC is associated with improved posterior support and decreased obstructive and irritative bowel symptoms at 1 year in women with apical and posterior prolapse.

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Acknowledgements

The Hitchcock Foundation (Dartmouth-Hitchcock Medical Center) provided financial support.

Conflicts of interest

Kris Strohbehn, M.D.: Society for Gynecologic Surgeons, Director of Post-Graduate Medicine, Executive Committee

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Authors and Affiliations

  1. Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women’s Hospital/Massachusetts General Hospital, Harvard Medical School, 75 Francis Street, ASB-3, Boston, MA, 02115, USA

    Daniel J. Kaser

  2. Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Dartmouth Medical School, Dartmouth-Hitchcock Medical Center, Lebanon, NH, 03756, USA

    Erron L. Kinsler, Todd A. Mackenzie, Paul Hanissian, Kris Strohbehn & James L. Whiteside

Authors
  1. Daniel J. Kaser
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  2. Erron L. Kinsler
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  3. Todd A. Mackenzie
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  4. Paul Hanissian
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  5. Kris Strohbehn
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  6. James L. Whiteside
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Correspondence to Daniel J. Kaser.

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Kaser, D.J., Kinsler, E.L., Mackenzie, T.A. et al. Anatomic and functional outcomes of sacrocolpopexy with or without posterior colporrhaphy. Int Urogynecol J 23, 1215–1220 (2012). https://doi.org/10.1007/s00192-012-1695-1

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  • DOI: https://doi.org/10.1007/s00192-012-1695-1

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