Abdominal sacrocolpopexy: A comprehensive review

To summarize published data about abdominal sacrocolpopexy and to highlight areas about which data are lacking. We conducted a literature search on MEDLINE using Ovid and PubMed, from January,1966 to January, 2004, using search terms "sacropexy," "sacrocolpopexy," "sacral co...

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Published inObstetrics and gynecology (New York. 1953) Vol. 104; no. 4; pp. 805 - 823
Main Authors NYGAARD, Ingrid E, MCCREERY, Rebecca, BRUBAKER, Linda, CONNOLLY, Annamarie, CUNDIFF, Geoff, WEBER, Anne M, ZYCZYNSKI, Halina
Format Journal Article
LanguageEnglish
Published New York, NY Elsevier Science 01.10.2004
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Abstract To summarize published data about abdominal sacrocolpopexy and to highlight areas about which data are lacking. We conducted a literature search on MEDLINE using Ovid and PubMed, from January,1966 to January, 2004, using search terms "sacropexy," "sacrocolpopexy," "sacral colpopexy," "colpopexy," "sacropexy," "colposacropexy," "abdominal sacrocolpopexy" "pelvic organ prolapse and surgery," and "vaginal vault prolapse or surgery" and included articles with English-language abstracts. We examined reference lists of published articles to identify other articles not found on the electronic search. We examined all studies identified in our search that provided any outcome data on sacrocolpopexy. Because of the substantial heterogeneity of outcome measures and follow-up intervals in case studies, we did not apply meta-analytic techniques to the data. Follow-up duration for most studies ranged from 6 months to 3 years. The success rate, when defined as lack of apical prolapse postoperatively, ranged from 78-100% and when defined as no postoperative prolapse, from 58-100%. The median reoperation rates for pelvic organ prolapse and for stress urinary incontinence in the studies that reported these outcomes were 4.4% (range 0-18.2%) and 4.9% (range 1.2% to 30.9%), respectively. The overall rate of mesh erosion was 3.4% (70 of 2,178). Some reports found more mesh erosions when concomitant total hysterectomy was done, whereas other reports did not. There were no data to either support or refute the contentions that concomitant culdoplasty or paravaginal repair decreased the risk of failure. Most authors recommended burying the graft under the peritoneum to attempt to decrease the risk of bowel obstruction; despite this, the median rate (when reported) of small bowel obstruction requiring surgery was 1.1% (range 0.6% to 8.6%). Few studies rigorously assessed pelvic symptoms, bowel function, or sexual function. Sacrocolpopexy is a reliable procedure that effectively and consistently resolves vaginal vault prolapse. Patients should be counseled about the low, but present risk, of reoperation for prolapse, stress incontinence, and complications. Prospective trials are needed to understand the effect of sacrocolpopexy on functional outcomes.
AbstractList To summarize published data about abdominal sacrocolpopexy and to highlight areas about which data are lacking. We conducted a literature search on MEDLINE using Ovid and PubMed, from January,1966 to January, 2004, using search terms "sacropexy," "sacrocolpopexy," "sacral colpopexy," "colpopexy," "sacropexy," "colposacropexy," "abdominal sacrocolpopexy" "pelvic organ prolapse and surgery," and "vaginal vault prolapse or surgery" and included articles with English-language abstracts. We examined reference lists of published articles to identify other articles not found on the electronic search. We examined all studies identified in our search that provided any outcome data on sacrocolpopexy. Because of the substantial heterogeneity of outcome measures and follow-up intervals in case studies, we did not apply meta-analytic techniques to the data. Follow-up duration for most studies ranged from 6 months to 3 years. The success rate, when defined as lack of apical prolapse postoperatively, ranged from 78-100% and when defined as no postoperative prolapse, from 58-100%. The median reoperation rates for pelvic organ prolapse and for stress urinary incontinence in the studies that reported these outcomes were 4.4% (range 0-18.2%) and 4.9% (range 1.2% to 30.9%), respectively. The overall rate of mesh erosion was 3.4% (70 of 2,178). Some reports found more mesh erosions when concomitant total hysterectomy was done, whereas other reports did not. There were no data to either support or refute the contentions that concomitant culdoplasty or paravaginal repair decreased the risk of failure. Most authors recommended burying the graft under the peritoneum to attempt to decrease the risk of bowel obstruction; despite this, the median rate (when reported) of small bowel obstruction requiring surgery was 1.1% (range 0.6% to 8.6%). Few studies rigorously assessed pelvic symptoms, bowel function, or sexual function. Sacrocolpopexy is a reliable procedure that effectively and consistently resolves vaginal vault prolapse. Patients should be counseled about the low, but present risk, of reoperation for prolapse, stress incontinence, and complications. Prospective trials are needed to understand the effect of sacrocolpopexy on functional outcomes.
OBJECTIVETo summarize published data about abdominal sacrocolpopexy and to highlight areas about which data are lacking.DATA SOURCESWe conducted a literature search on MEDLINE using Ovid and PubMed, from January,1966 to January, 2004, using search terms "sacropexy," "sacrocolpopexy," "sacral colpopexy," "colpopexy," "sacropexy," "colposacropexy," "abdominal sacrocolpopexy" "pelvic organ prolapse and surgery," and "vaginal vault prolapse or surgery" and included articles with English-language abstracts. We examined reference lists of published articles to identify other articles not found on the electronic search.METHODS OF STUDY SELECTIONWe examined all studies identified in our search that provided any outcome data on sacrocolpopexy. Because of the substantial heterogeneity of outcome measures and follow-up intervals in case studies, we did not apply meta-analytic techniques to the data.TABULATION, INTEGRATION, AND RESULTSFollow-up duration for most studies ranged from 6 months to 3 years. The success rate, when defined as lack of apical prolapse postoperatively, ranged from 78-100% and when defined as no postoperative prolapse, from 58-100%. The median reoperation rates for pelvic organ prolapse and for stress urinary incontinence in the studies that reported these outcomes were 4.4% (range 0-18.2%) and 4.9% (range 1.2% to 30.9%), respectively. The overall rate of mesh erosion was 3.4% (70 of 2,178). Some reports found more mesh erosions when concomitant total hysterectomy was done, whereas other reports did not. There were no data to either support or refute the contentions that concomitant culdoplasty or paravaginal repair decreased the risk of failure. Most authors recommended burying the graft under the peritoneum to attempt to decrease the risk of bowel obstruction; despite this, the median rate (when reported) of small bowel obstruction requiring surgery was 1.1% (range 0.6% to 8.6%). Few studies rigorously assessed pelvic symptoms, bowel function, or sexual function.CONCLUSIONSacrocolpopexy is a reliable procedure that effectively and consistently resolves vaginal vault prolapse. Patients should be counseled about the low, but present risk, of reoperation for prolapse, stress incontinence, and complications. Prospective trials are needed to understand the effect of sacrocolpopexy on functional outcomes.
Author CUNDIFF, Geoff
ZYCZYNSKI, Halina
CONNOLLY, Annamarie
MCCREERY, Rebecca
BRUBAKER, Linda
NYGAARD, Ingrid E
WEBER, Anne M
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  fullname: MCCREERY, Rebecca
  organization: Baylor College of Medicine, Houston, Texas, United States
– sequence: 3
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  surname: BRUBAKER
  fullname: BRUBAKER, Linda
  organization: Baylor College of Medicine, Houston, Texas, United States
– sequence: 4
  givenname: Annamarie
  surname: CONNOLLY
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  organization: Baylor College of Medicine, Houston, Texas, United States
– sequence: 5
  givenname: Geoff
  surname: CUNDIFF
  fullname: CUNDIFF, Geoff
  organization: Baylor College of Medicine, Houston, Texas, United States
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  fullname: WEBER, Anne M
  organization: Baylor College of Medicine, Houston, Texas, United States
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  givenname: Halina
  surname: ZYCZYNSKI
  fullname: ZYCZYNSKI, Halina
  organization: Baylor College of Medicine, Houston, Texas, United States
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https://www.ncbi.nlm.nih.gov/pubmed/15458906$$D View this record in MEDLINE/PubMed
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Snippet To summarize published data about abdominal sacrocolpopexy and to highlight areas about which data are lacking. We conducted a literature search on MEDLINE...
OBJECTIVETo summarize published data about abdominal sacrocolpopexy and to highlight areas about which data are lacking.DATA SOURCESWe conducted a literature...
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SubjectTerms Biological and medical sciences
Female
Gynecology. Andrology. Obstetrics
Humans
Medical sciences
Outcome Assessment (Health Care)
Postoperative Complications
Sacrum - surgery
Suture Techniques
Treatment Outcome
United States
Urogenital Surgical Procedures - adverse effects
Urogenital Surgical Procedures - methods
Uterine Prolapse - surgery
Title Abdominal sacrocolpopexy: A comprehensive review
URI https://www.ncbi.nlm.nih.gov/pubmed/15458906
https://search.proquest.com/docview/66933329
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