- For different types of hysteropexies, few studies have compared outcomes, even though approaches have a wide range of risk for pelvic organ prolapse (POP) recurrence and adverse events (AEs).
Why this matters
- Surgeons with patients who desire uterine preservation during POP surgery should be cautious about offering 1 type of hysteropexy over another, say researchers. But they should counsel patients that minimally invasive approaches can limit morbidity or operating time.
- Researchers analyzed 99 comparative or single-group studies involving the following surgery types:
- open mesh sacrohysteropexy (SHP),
- laparoscopic or robotic-assisted mesh SHP,
- other open abdominal hysteropexy procedures (non-SHP),
- other laparoscopic or robotic-assisted hysteropexy procedures (non-SHP).
- transvaginal mesh hysteropexy,
- transvaginal native-tissue hysteropexies such as sacrospinous hysteropexy or uterosacral, hysteropexy,
- Manchester procedure, and
- LeFort colpocleisis.
- Funding: Society of Gynecologic Surgeons.
- Repeat POP surgery after hysteropexy varied widely by hysteropexy type (0%-29%).
- Laparoscopic vs open hysteropexies had:
- Lower POP recurrence: OR, 0.18 (95% CI, 0.07-0.46);
- Urinary retention: OR, 0.05 (95% CI, 0.003-0.83); and
- Blood loss: mean difference, −104 mL (95% CI, −145 to −63 mL).
- Common AEs included mesh exposure (0%-39%), urinary retention (0%-80%), and sexual dysfunction (0%-48%).
- Studies were heterogeneous and most were of poor quality.