Sacrospinous hysteropexy compared to vaginal hysterectomy as primary surgical treatment for a descensus uteri: effects on urinary symptoms
One hundred and three women underwent sacrospinous hysteropexy (n=54) or vaginal hysterectomy with a vaginal vault suspension (n=49) for the management of descensus uteri. They were sent a postal questionnaire. Logistic regression analysis was used to obtain crude and adjusted odds ratios. Seventy-four (72%) women responded. The adjusted odds ratios for urge incontinence is 3.4 (1.0–12.3) and for overactive bladder 2.9 (0.5–16.9) greater after vaginal hysterectomy. The women recovered significantly more quickly after sacrospinous hysteropexy. There were no differences in anatomical outcome or recurrence rate. When performed to correct a descensus uteri of grade 2 or more we found that vaginal hysterectomy is associated with a three times higher risk for urge incontinence and overactive bladder symptoms. In addition, the women who underwent sacrospinous hysteropexy also reported a quicker recovery from surgery. Sacrospinous hysteropexy, therefore, appears to be promising for the correction of descensus uteri.
KeywordsCorrection of descensus uteri Micturition symptoms Sacrospinous hysteropexy Vaginal hysterectomy.
- 1.SIG Zorg-informatie, Utrecht, Landelijke Medische Registratie 1995–1999, leeftijdscategorie 15 jaar en ouder. SIG Zorginformatie 2002Google Scholar
- 4.Kuh D, Cardozo L, Hardy R (1999) Urinary incontinence in middle aged women: childhood enuresis and other lifetime risk factors in a British prospective cohort. J Epidemiol CommunHealth 53:453–458Google Scholar
- 5.van der Vaart CH, van der Bom JC, de Leeuw JRJ, Roovers JPWR, Heintz APM (2002) The contribution of hysterectomy to the occurence of urge- and stress urinary incontinence symptoms. Br J Obstet Gynaecol 109:149–154Google Scholar
- 18.Vaart van der CH, de Leeuw JRJ, Roovers JPWR, Heintz APM (2003) Measuring health-related quality of life in women with urogenital dysfunction: the urogenital distress inventory and incontinence impact questionnaire revisited. Neurourol Urodyn 22(2): 97–104Google Scholar
- 21.Kuh D, Cardozo L, Hardy R (1999) Urinary incontinence in middle aged women: childhood enuresis and other lifetime risk factors in a British prospective cohort. J Epidemiol Commun Health 53:453–458Google Scholar
- 24.Wyman JF, Choi SC, Harkins SW, Wilson MS, Fantl JA (1998) The urinary diary in evaluation of incontinent women: a test-retest analysis. Obstet Gynecol 71:812–817Google Scholar
- 26.Overactive Bladder and Its Treatments Consensus Conference. London, United Kingdom, 4July 1999. Urology 2000; 55:1–84Google Scholar
- 28.Bonney V (1934) The principles that should underlie all operations for prolapse. J Obstet Gynaecol Br Emp 41:669–683Google Scholar