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Treatment of vaginal vault prolapse in The Netherlands: a clinical practice survey

  • Carolien K. M. Vermeulen
  • Anne Lotte W. M. Coolen
  • Wilbert A. Spaans
  • Jan Paul W. R. Roovers
  • Marlies Y. Bongers
Original Article
  • 27 Downloads

Abstract

Introduction and hypothesis

A great variety of conservative and surgical procedures to correct vaginal vault prolapse have been reported. The aim of this study was to describe practice pattern variation—the difference in care that cannot be explained by the underlying medical condition—among Dutch gynecologists regarding treatment of vaginal vault prolapse.

Methods

A clinical practice survey was conducted from March to April 2017. The questionnaire was developed to evaluate treatment of vaginal vault prolapse. All members of the Dutch Society for Urogynaecology were invited to participate in a web-based survey.

Results

One hundred four Dutch gynecologists with special interest in urogynecology responded to the survey (response rate, 44%). As first-choice therapy for vaginal vault prolapse, 78% of the respondents chose pessary treatment, whereas sacrospinous fixation was the second most common therapy choice according to 64% of the respondents. Preferences on how to approach vaginal vault prolapse surgically are conflicting. Overall, the most performed surgery for vaginal vault prolapse is sacrospinous fixation, followed by laparoscopic and robotic sacrocolpopexy.

Conclusions

Gynecologists in The Netherlands manage vaginal vault prolapse very differently. No standardized method could be determined for the treatment of vaginal vault prolapse in The Netherlands, and we observed practice pattern variations.

Keywords

Vaginal vault prolapse Treatment Sacrocolpopexy Trans vaginal mesh Sacrospinous fixation Pessary 

Abbreviations

ASC

Abdominal sacrocolpopexy

IUGA

International Urogynaecology Association

LSC

Laparoscopic sacrocolpopexy

NTR

Dutch Trial Register

POP

Pelvic organ prolapse

PPV

Practice pattern variation

SPSS

Statistical Package for the Social Sciences

SSF

Sacrospinous fixation

RSC

Robotic sacrocolpopexy

VVP

Vaginal vault prolapse

Notes

Acknowledgements

We thank the Dutch Society for Urogynaecology for sending our survey to the gynecologists and to all who contributed to this paper by responding to our questionnaire.

Compliance with ethical standards

Conflicts of interest

None.

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Copyright information

© The International Urogynecological Association 2018

Authors and Affiliations

  1. 1.Department of Gynaecology and ObstetricsMáxima Medical CentreVeldhovenThe Netherlands
  2. 2.Department of Gynaecology and ObstetricsGrow, Research School of Oncology and Developmental Biology, University of MaastrichtMaastrichtThe Netherlands
  3. 3.Department of Gynaecology and ObstetricsMaastricht Academic HospitalMaastrichtThe Netherlands
  4. 4.Department of Gynaecology and ObstetricsAcademic Medical Centre AmsterdamAmsterdamThe Netherlands

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