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Long‐term outcomes and five‐year recurrence‐free survival curves after native‐tissue prolapse repair
Author(s) -
Deo Giuseppe,
Bernasconi Davide P.,
Cola Alice,
Palmieri Stefania,
Spelzini Federico,
Milani Rodolfo,
Manodoro Stefano,
Frigerio Matteo
Publication year - 2019
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12938
Subject(s) - medicine , uterosacral ligament , surgery , retrospective cohort study , ligament , risk factor , vagina
Objective To evaluate the long‐term objective and subjective outcomes to build recurrence‐free survival curves after mesh‐free uterosacral ligament suspension and to evaluate the long‐term impact of prognostic factors on outcome measures. Methods A retrospective study analyzed 5‐year follow‐up after repair of primary prolapse through high uterosacral ligament suspension. Bulging symptoms and post‐operative prolapse stage II or above were considered subjective and objective recurrences, respectively. The cumulative proportion of relapse‐free patients in time was analyzed by Kaplan‐Meier curves. Results A total of 353 women were analyzed. Five‐year recurrence rates were 15.0% for objective recurrence, 13.0% for subjective recurrence, and 4.0% for the combined objective and subjective recurrences. Premenopausal status was shown to be a risk factor for anatomic ( P =0.022), symptomatic ( P =0.001), and combined ( P =0.047) recurrence. Conversely, anterior repair was shown to be a protective factor for symptomatic ( P =0.012) and combined ( P =0.002) recurrence. Most of the recurrences occurred within 2 years after surgery. Conclusion Long‐term outcomes after high uterosacral ligament suspension were satisfactory. Premenopausal status and lack of anterior repair represented risk factors for recurrence in the long term.