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Surgical outcomes in patients aged 70 years and older following uterosacral ligament suspension: a comparative study

  • Urogynecology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

The number of elderly patients bothered by pelvic organ prolapse symptoms is growing rapidly. The aim of this study was to evaluate the relationship between age and surgical outcomes in women undergoing uterosacral ligament suspension for treatment of apical prolapse.

Methods

We performed a retrospective cohort study including women who underwent uterosacral ligament suspension between 2010 and 2020. The cohort was divided into two groups: (1) Patients 70 years or older; (2) Patients under the age of 70. Outcome measures included clinical, anatomical, and composite outcomes as well as patient satisfaction.

Results

A total of 271 patients were included in the final analysis. Of them 209 patients were under age 70 and 62 patients 70 years or older. Mean age was 59 ± 6 vs. 73 ± 3 for the young and elderly age groups, respectively. Clinical success was high for both groups, reaching 94% vs. 89% for elderly and young patients, respectively (p = 0.34). Anatomical and composite outcome success were higher in the young age group (76% vs. 56%, p < 0.01 and 70% vs. 54%, p = 0.02, respectively); however, following multivariate analysis these differences were no longer statistically significant.

Following multivariate logistic regression analysis for the dependent parameter of anatomical success, increased pre-operative genital hiatus and vaginal surgical route were associated with anatomical failure while performing a concomitant posterior colporrhaphy increased likelihood for anatomical success.

Conclusion

Women over the age of 70 undergoing uterosacral ligament suspension for treatment of apical prolapse have comparable outcomes to younger patients.

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Data availability

The data that support the findings of this study are available on request from the corresponding author, [HHC].

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Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Author notes

  1. Henry H. Chill and Aharon Dick have contributed equally to this work.

Authors and Affiliations

  1. Division of Urogynecology, University of Chicago Pritzker School of Medicine, NorthShore University HealthSystem, Skokie, IL, USA

    Henry H. Chill

  2. Department of Obstetrics and Gynecology, Hadassah–Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel

    Aharon Dick, Adiel Cohen, Ina Ryvkin, Joshua I. Rosenbloom, Adi Reuveni-Salzman & David Shveiky

  3. Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Hadassah–Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel

    Adi Reuveni-Salzman & David Shveiky

Authors
  1. Henry H. Chill
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  2. Aharon Dick
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  3. Adiel Cohen
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  4. Ina Ryvkin
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Contributions

Chill: project development, data collection, data analysis, manuscript writing and editing. Dick: project development, data collection, data analysis, manuscript writing and editing. Cohen: data collection, data analysis, manuscript editing. Ryvkin: manuscript writing and editing. Rosenbloom: data analysis, manuscript editing. Reuveni-Salzman: data collection, data analysis. Manuscript writing. Shveiky: project development, data analysis, manuscript writing and editing. All authors approved the final version of the manuscript.

Corresponding author

Correspondence to Henry H. Chill.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Hadassah Medical Center (IRB 0444-20-HMO).

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Chill, H.H., Dick, A., Cohen, A. et al. Surgical outcomes in patients aged 70 years and older following uterosacral ligament suspension: a comparative study. Arch Gynecol Obstet 307, 2033–2040 (2023). https://doi.org/10.1007/s00404-023-06974-1

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  • DOI: https://doi.org/10.1007/s00404-023-06974-1

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