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Patient-reported outcomes after sacrospinous fixation of vault prolapse with a suturing device: a retrospective national cohort study
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynecology. National Quality Register of Gynecological Surgery, Umeå, Sweden.
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2018 (English)In: International Urogynecology Journal, ISSN 0937-3462, E-ISSN 1433-3023, Vol. 29, no 6, p. 821-829Article in journal (Refereed) Published
Abstract [en]

Introduction and hypothesis: Innovations in suturing devices have facilitated sacrospinous ligament fixation (SSF) for the correction of vaginal vault prolapse. It is uncertain if outcomes using suturing devices differ from those using a traditional suturing technique. We hypothesize that no difference exists in the efficacy and safety 1 year after SSF for vault prolapse performed with suturing devices or using a traditional technique. The objective was to compare SSF using a suturing device with traditional SSF for the treatment of vault prolapse, regarding symptoms of prolapse recurrence, patient satisfaction, incidence of re-operation, and complications 1 year postoperatively.

Methods: We carried out a retrospective cohort study using register-based national data from 2006 to 2013. The Swedish Quality Register of Gynecological Surgery includes assessments pre-operatively, at hospital admittance, surgery, discharge, and questionnaires at 8 weeks and 1 year after surgery. Demographic variables and surgical methods were included in multivariate logistic regression analyses.

Results: In the suturing device group (SDG, n = 353), 71.5% were asymptomatic of recurrence after 1 year compared with 78.7% in the traditional SSF group (TSG, n = 195); risk difference - 7.3% (95%CI -15.2%; 0.7%). Adjusted odds ratio (aOR) for being asymptomatic 1 year postoperatively was 0.56 (95%CI 0.31; 1.02, p = 0.057). Patient satisfaction was similar in SDG and TSG (78.1% vs 78.4%). Reoperation occurred in 7.4% in the SDG compared with 3.6% in the TSG, risk difference 3.8% (95%CI 0.0%; 7.5%), aOR 3.55 (95%CI 1.10; 11.44, p = 0.03).

Conclusions: Patient satisfaction was similar 1 year after SSF, despite symptoms of recurrence being more likely and reoperation more common after using a suturing device compared with a traditional technique. The methods did not differ with regard to surgical complications.

Place, publisher, year, edition, pages
Springer, 2018. Vol. 29, no 6, p. 821-829
Keywords [en]
patient-reported outcome, sacrospinous ligament fixation, suturing device, vault prolapse
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
URN: urn:nbn:se:umu:diva-148015DOI: 10.1007/s00192-017-3491-4ISI: 000431930700007PubMedID: 28988359OAI: oai:DiVA.org:umu-148015DiVA, id: diva2:1211397
Available from: 2018-05-30 Created: 2018-05-30 Last updated: 2018-06-09Bibliographically approved

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Nüssler, Emil

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