Journal article
Prospective evaluation of genital hiatus in patients undergoing surgical prolapse repair
INTERNATIONAL UROGYNECOLOGY JOURNAL, Vol.33(11), pp.3247-3254
11/01/2022
DOI: 10.1007/s00192-022-05157-x
PMCID: PMC8929254
PMID: 35301543
Abstract
Introduction and hypothesis Enlarged genital hiatus (GH) is associated with prolapse recurrence following prolapse repair. Perineorrhaphy is often performed to reduce GH. However, changes in GH between the time of surgery and follow up are poorly understood. Our primary aim was to compare the intra-operative resting GH at the conclusion of surgery with the resting GH 3 months post-operatively in patients who undergo perineorrhaphy. We hypothesized that the intra-operative resting GH would be sustained. Methods Patients planning apical prolapse surgery were prospectively enrolled. Perineorrhaphy was performed at the surgeon's discretion. GH was measured pre-operatively in clinic, intra-operatively before and after surgery (resting), and 3 months post-operatively (resting and Valsalva). Results Twenty-nine perineorrhaphy and 27 no perineorrhaphy patients completed 3-month follow-up. Groups were similar in age (63.9 y, SD 10.4), body mass index (28.3 kg/m(2), SD 5.2) and prior prolapse surgery (19.6%). Median (interquartile range) baseline Valsalva GH was larger in the perineorrhaphy group (4.5 (4 - 5.5) vs 3.5 (3 - 4) cm, p < 0.01). Median resting GH at 3 months was 0.5 cm less than end of surgery in the perineorrhaphy group (p < 0.01). The median change in GH between baseline and 3-month follow up was greater with perineorrhaphy (-1.5 vs -0.5 cm, p < 0.01). This difference was not seen in the sacrocolpopexy subgroup (-1.75 vs -1.5, p = 0.14; n = 24). Conclusions Surgeons can be reassured that the intra-operative change in GH resulting from perineorrhaphy is sustained 3 months after surgery and similar to the more commonly measured preoperative to postoperative change in Valsalva GH.
Details
- Title: Subtitle
- Prospective evaluation of genital hiatus in patients undergoing surgical prolapse repair
- Creators
- Mildrede Bonglack - University of Iowa Hospitals and ClinicsErin Maetzold - University of Iowa Hospitals and ClinicsKimberly A. Kenne - University of Iowa Hospitals and ClinicsCatherine S. Bradley - University of Iowa Hospitals and ClinicsJoseph T. Kowalski - University of Iowa Hospitals and Clinics
- Resource Type
- Journal article
- Publication Details
- INTERNATIONAL UROGYNECOLOGY JOURNAL, Vol.33(11), pp.3247-3254
- DOI
- 10.1007/s00192-022-05157-x
- PMID
- 35301543
- PMCID
- PMC8929254
- NLM abbreviation
- Int Urogynecol J
- ISSN
- 0937-3462
- eISSN
- 1433-3023
- Publisher
- Springer Nature
- Number of pages
- 8
- Language
- English
- Date published
- 11/01/2022
- Academic Unit
- Epidemiology; Obstetrics and Gynecology; Urology
- Record Identifier
- 9984318228702771
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