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A Randomised Trial on the Effects of the Addition of Uterosacral Ligament Plication to Pectopexy Operation on Anatomical Restoration and Female Sexual Functions

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Abstract

Introduction and hypothesis

The objective was to determine whether the addition of uterosacral ligament plication to pectopexy for pelvic organ prolapse increases anatomical improvement and female sexual functioning.

Methods

This is a prospective randomised study. Forty patients who underwent laparoscopic pectopexy (LP) and laparoscopic pectopexy with uterosacral ligament plication (LPUSL) were included in the study. A total of 38 patients were evaluated in the study. Patients were assessed by the Pelvic Organ Prolapse Quantification (POP-Q) system and the patients who had symptomatic apical prolapse POP-Q ≥ II were included in the study. Patients were evaluated preoperatively and postoperatively at the 3rd, 6th and 12th month, with respect to anatomical changes as well as sexual function.

Results

A statistically significant difference was found when the preoperative C points was compared with the C points postoperatively, at 3rd, 6th and 12th months in both the LP and LPUSL groups (p < 0.001). Additionally, there were statistically significant difference between the LP and LPUSL groups in terms of C and Aa points at the 6th and 12th postoperative months in favour of the LPUSL group (p = 0.007, p = 0.005 respectively). There was also a statistically significant difference when Ba points were compared between the two groups at the 12th postoperative month, in favour of the LPUSL group (p = 0.002). There were no statistically significant differences between the groups with respect to the variables of the Female Sexual Function Index. Additionally, all parameters were significantly better in both groups at the 3rd and 12th months than the preoperative values in post hoc analysis; only desire also had a significant improvement between the 3rd and 12th months in the LPUSL group in post hoc analysis.

Conclusion

Pectopexy operation seems to be a successful surgical approach as an alternative to sacrocolpopexy. The addition of uterosacral ligament plication to pectopexy operation improves the anatomical restoration more drastically than with LP on its own. Moreover, either LP or LPUSL has improved the majority of sexual function indices.

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Data Availability

All data are available.

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Acknowledgements

The authors thank Esin Gökçen, surgery nurse, for the laparoscopic set-up and surgical nursing.

Funding

There is no funding for this study.

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Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, Ataturk University, Erzurum, Turkey

    Yakup Kumtepe, Gamze Nur Cimilli Senocak, Aysenur Yapar & Emsal Pinar Topdagi Yilmaz

  2. Department of Obstetrics and Gynaecology, Muğla Sıtkı Koçman Education and Research Hospital, Mugla, Turkey

    Ahmet Akın Sivaslioglu

  3. Department of Biostatistics, Ataturk University, Erzurum, Turkey

    Kamber Kasali

  4. Anesthesiology Clinical Research Office Member, Ataturk University, Erzurum, Turkey

    Yakup Kumtepe, Gamze Nur Cimilli Senocak, Emsal Pinar Topdagi Yilmaz & Kamber Kasali

Authors
  1. Yakup Kumtepe
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  3. Ahmet Akın Sivaslioglu
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Contributions

Y. Kumtepe: project development, data collection, manuscript writing, manuscript editing; G.N. Cimilli Senocak: project development, data collection, manuscript writing, manuscript editing; A.A. Sivaslioglu: making statistical analysis, data collection, manuscript writing; A. Yapar: data collection; E.P. Topdagi Yilmaz: data collection; K. Kasali: data analysis and manuscript editing.

Corresponding author

Correspondence to Yakup Kumtepe.

Ethics declarations

Clinical trial registry number

Clinical trials identifier number NCT04508062.

Date and number of IRB

This prospective, randomised trial was approved by the ethics committee of Erzurum Atatürk University with number B.30.2.ATA.0.01.00/236 and date 22 April 2019.

Conflicts of Interest

None.

Additional information

Handling Editor: Jaromir Masata

Editor in Chief: Maria A. Bortolini

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Kumtepe, Y., Senocak, G.N.C., Sivaslioglu, A.A. et al. A Randomised Trial on the Effects of the Addition of Uterosacral Ligament Plication to Pectopexy Operation on Anatomical Restoration and Female Sexual Functions. Int Urogynecol J (2024). https://doi.org/10.1007/s00192-024-05771-x

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