Journal article
What happens to the posterior compartment and bowel symptoms after sacrocolpopexy? Evaluation of 5-year outcomes from E-Care
Female pelvic medicine & reconstructive surgery, Vol.20(5), pp.261-266
2014
DOI: 10.1097/SPV.0000000000000085
PMCID: PMC4159620
PMID: 25181375
Abstract
Objectives: The objective of this study was to describe posterior prolapse (pPOP) and obstructed defecation (OD) symptoms 5 years after open abdominal sacrocolpopexy (ASC).
Methods: We grouped the extended colpopexy and urinary reduction efforts trial participants with baseline and 5-year outcomes into 3 groups using baseline posterior Pelvic Organ Prolapse Quantification (POP-Q) points and concomitant posterior repair (PR) (no PR, Ap <0; no PR, Ap ≥0; and +PR). Posterior colporrhaphy, perineorrhaphy, or sacrocolpoperineopexy were included as PR, which was performed at surgeon's discretion. Outcomes were dichotomized into presence/absence of pPOP (Ap ≥0) and OD symptoms (≥2 on 1 or more questions about digital assistance, excessive straining, or incomplete evacuation). Composite failure was defined by both pPOP and OD symptoms or pPOP reoperation.
Results: Ninety participants completed baseline and 5-year outcomes or were retreated with mean follow-up of 7.1 ± 1.0 years. Of those with no PR (Ap <0), 2 women (2/36; 9%) developed new pPOP with OD symptoms; 1 underwent subsequent PR. Nearly all (23/24; 96%) with no PR (Ap ≥0) demonstrated sustained resolution of pPOP, and none underwent PR. Fourteen percent (4/29) of +PR underwent repeat PR within 5 years, and 12% had recurrent pPOP. Regardless of PR, OD symptoms improved in all groups after ASC, although OD symptoms were still present in 17% to 19% at 5 years.
Conclusions: Symptomatic pPOP is common 5 years after ASC regardless of concomitant PR. Obstructed defecation symptoms may improve after ASC regardless of PR. Recurrent pPOP and/or reoperation was highest among those who received concomitant PR at ASC. Further studies identifying criteria for concomitant PR at the time of ASC are warranted.
Details
- Title: Subtitle
- What happens to the posterior compartment and bowel symptoms after sacrocolpopexy? Evaluation of 5-year outcomes from E-Care
- Creators
- Cara Grimes - Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, USAEmily S Lukacz - Department of Reproductive Medicine, UC San Diego Health Systems, San Diego, California, USAMarie G Gantz - RTI International, Research Triangle Park, NC, USALauren Klein Warren - RTI International, Research Triangle Park, NC, USALinda Brubaker - Departments of Obstetrics & Gynecology and Urology, Stritch School of Medicine, Loyola University, Chicago, Illinois, USAHalina M Zyczynski - Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USAHolly E Richter - Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama, USAJ. Eric Jelovsek - Obstetrics, Gynecology& Women’s Health Institute Cleveland Clinic, Cleveland, Ohio, USAGeoffrey Cundiff - Department of Obstetrics & Gynaecology, University of British Columbia, CanadaPaul Fine - Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas, USAAnthony G Visco - Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina, USAMin Zhang - Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USASusan Meikle - TheNICHD Pelvic Floor Disorders Network
- Contributors
- Karl J Kreder (Contributor) - University of Iowa, Urology
- Resource Type
- Journal article
- Publication Details
- Female pelvic medicine & reconstructive surgery, Vol.20(5), pp.261-266
- DOI
- 10.1097/SPV.0000000000000085
- PMID
- 25181375
- PMCID
- PMC4159620
- NLM abbreviation
- Female Pelvic Med Reconstr Surg
- ISSN
- 2151-8378
- eISSN
- 2154-4212
- Language
- English
- Date published
- 2014
- Academic Unit
- Obstetrics and Gynecology; Urology
- Record Identifier
- 9984051542802771
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