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Safety and one year outcomes following vaginally assisted laparoscopic uterine sacropexy (VALUES) for advanced uterine prolapse

Authors

  • Abdalla M. Fayyad,

    Corresponding author
    1. Department of Obstetrics and Gynecology, Luton and Dunstable University Hospital NHS Foundation Trust, Luton, United Kingdom
    • Correspondence to: Abdalla Fayyad, M.D., MRCOG, Consultant, Department of Obstetrics and Gynecology, Luton and Dunstable Hospital NHS Foundation Trust, Lewsey Road, Luton LU4 0DZ, United Kingdom.

      E-mail: abdalla.fayyad@ldh.nhs.uk

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  • Chrysostomos S. Siozos

    1. Department of Obstetrics and Gynecology, Luton and Dunstable University Hospital NHS Foundation Trust, Luton, United Kingdom
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  • Heinz Koelbl led the peer-review process as the Associate Editor responsible for the paper.
  • Conflict of interest: None.
  • Contribution to authorship—A. Fayyad: Designed the study, analyzed the data, written the manuscript. C. Siozos: Analyzed the data, written the manuscript.
  • Details of ethical approval: Interventional Procedures Governance Committee of the Luton and Dunstable University Hospital approved the procedure as a modification of established technique (sacrohysteropexy), with regular audit of outcomes.
  • Presentation information: 38th Annual Society of Gynecologic Surgeons (SGS) Scientific Meeting, Baltimore, MD, April 13–15, 2012.

Abstract

Aims

To assess the safety and outcomes of vaginally assisted laparoscopic uterine sacropexy (VALUES) as a surgical treatment for stage 3 and 4 uterine prolapse.

Methods

Seventy consecutive women with stage 3 and 4 uterine prolapse who underwent VALUES over 2-year period were prospectively evaluated. Women filled the Prolapse Quality of Life Questionnaire (P-QOL), and underwent examination using pelvic organ prolapse quantification system (POP-Q) pre- and post-operatively. In addition, patients filled the patient global impression of improvement questionnaire post-operatively. Mesh related complications were evaluated post-operatively. Patients were followed up at 3 and 12 months following surgery. This study reports the 12 months outcomes.

Results

Sixty-four women (91.4%) reported cure of their prolapse symptoms. On examination, 67 women (95.7%) had POP-Q stage 0 or 1 uterine support at 12 months. Six women needed further surgical intervention for prolapse (8.5%); three women developed recurrent uterine prolapse and three other women developed symptomatic recurrent anterior vaginal wall prolapse. The total vaginal length was not different between the pre- and post-operative periods. Two patients developed mesh related complications. Significant improvement was noted in prolapse symptoms and quality of life.

Conclusions

VALUES is a safe and effective treatment for women with stage 3 and 4 uterine prolapse up to 12 months without the risk of vaginal shortening. Long-term results are needed to fully establish the value of this technique. Neurourol. Urodynam. 33:345–349, 2014. © 2013 Wiley Periodicals, Inc.

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