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Trends in apical prolapse surgery between 2010 and 2016 in Denmark

  • Karen Ruben HusbyEmail author
  • Gunnar Lose
  • Niels Klarskov
Original Article
  • 13 Downloads

Abstract

Introduction and hypothesis

Pelvic organ prolapse is a common diagnosis. Today there is no consensus on the ideal operation technique for apical prolapse. Vaginal hysterectomy with suspension of the vaginal cuff is the most frequently used, but the popularity of uterus-preserving techniques is increasing. The aim of this study was to describe trends in surgical techniques used to treat primary apical prolapse in Danish hospitals.

Methods

Data were obtained from the Danish Urogynecological Database and included women with primary prolapse surgery in the apical compartment operated in Denmark 2010–2016. Public hospital departments were divided into three categories according to degree of urogynecological specialization: high level, moderate level, and no specialization.

Results

The number of vaginal hysterectomies decreased and the number of uterus-preserving operations increased from 2010 to 2016. The proportion of uterus-preserving techniques versus vaginal hysterectomy differed substantially between different hospital types. At departments with high and moderate levels of specialization, uterus-preserving techniques increased during the period, accounting for nearly 90% and 40%, respectively, in 2016, while decreasing to < 35% for departments with no specialization.

Three of the four departments with high-level specialization preferred the Manchester-Fothergill procedure, while one preferred sacrospinous hysteropexy.

Only 2.3% of all procedures were performed at private hospitals.

Conclusions

The proportion of uterus-preserving techniques to treat apical prolapse increased from 2010 to 2016. However, there is a wide variation in practice at the different hospitals. An agreement on uterus-preserving techniques has not been reached.

Keywords

Pelvic organ prolapse (POP) Apical prolapse Manchester-Fothergill procedure Vaginal hysterectomy Sacrospinous hysteropexy 

Abbreviations

ASA

The American Society of Anesthesiologist

BMI

Body mass index

DugaBase

The Danish Urogynecological Database

MP

Manchester-Fothergill procedure

SH

Sacrospinous hysteropexy

VH

Vaginal hysterectomy with suspension of the vaginal cuff

Notes

Compliance with ethical standards

Conflicts of interest

K.R. Husby has no financial disclaimers.

G. Lose has no disclosures.

N. Klarskov has, outside the study, received personal fees from Astellas Pharma.

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Copyright information

© The International Urogynecological Association 2019

Authors and Affiliations

  1. 1.Department of Obstetrics and GynecologyHerlev and Gentofte University HospitalHerlevDenmark
  2. 2.University of CopenhagenCopenhagenDenmark

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