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Long‐term results of prolapse recurrence and functional outcome after vaginal hysterectomy
Author(s) -
Prodigalidad Lisa T.,
Peled Yoav,
Stanton Stuart L.,
Krissi Haim
Publication year - 2013
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 - 10.1016/j.ijgo.2012.07.022
Subject(s) - medicine , hysterectomy , urinary incontinence , incidence (geometry) , uterine prolapse , stress incontinence , vaginal vault prolapse , vagina , gynecology , surgery , obstetrics , physics , optics
Objective To evaluate the incidence of prolapse and prolapse‐related symptoms following vaginal hysterectomy. Methods Data were reviewed from women who underwent vaginal hysterectomy between 1988, and 1995, at St George's Hospital, London, UK, and attended long‐term follow‐up. Outcome measures included a questionnaire for prolapse, urinary, bowel, and sexual symptoms; and a vaginal examination. Results Among 94 women attending long‐term evaluation, the mean follow‐up time was 100.7 months (range 67.0–156.0 months). Before vaginal hysterectomy, urgency was noted among 23 (24.5%), urge incontinence among 11 (11.7%), and stress incontinence among 8 (8.5%) women. At follow‐up, these symptoms were observed among 23 (24.5%), 13 (13.8%), and 6 (6.4%) women, respectively. De novo urge incontinence and de novo stress incontinence were observed among 3 (3.2%) and 2 (2.1%) women, respectively. Vaginal examination data were compared for 70 women, of whom 18 (25.7%) had grade 1, 40 (57.1%) had grade 2, and 6 (8.6%) had grade 3 uterine prolapsed before surgery. Postoperatively, vaginal vault prolapse occurred in 7 (10.0%) women and correlated with degree of posterior prolapse ( P = 0.007), but not with severity of uterine descent ( P = 0.205) or previous prolapse surgery ( P = 0.573). Conclusion The incidence of post‐hysterectomy vault prolapse correlated with the degree of preoperative rectocele.