[en] OBJECTIVE: To evaluate the place of subtotal hysterectomy during laparoscopic sacrocolpopexy. METHODS: This retrospective observational study includes patients undergoing laparoscopic sacrocolpopexy between November 2010 and March 2015 at the Centre Hospitalier Regional de la Citadelle, Liege, Belgium. Patient characteristics, medical and surgical history were collected. Clinical data, operative and intraoperative complications were analyzed. The postoperative results were collected at 6 weeks, 4 months and then every year with a clinical and anatomical evaluation by POP-Q (Pelvic Organ Prolapse - Quantification). RESULTS: Ninety-four patients were included in the study. Sixty-four patients (68.1%) underwent sacrocolpopexy with subtotal hysterectomy, 12 patients (12.7%) had sacrocolpopexy with uterine preservation, 16 patients (17%) had a clinical history of hysterectomy and 2 patients (2.2%) have had sacrocolpopexy with total hysterectomy. The mean age of the patients was 61+/-20 years, parity 2+/-2 and BMI 25.2+/-7.32. The objective success rate, defined by a stage of POP-Q<2, was 93.75% in the sacrocolpopexy group with subtotal hysterectomy vs. 66.7% in the sacrocolpopexy group with uterine preservation (P=0.019). The subjective success rates were 98.4% and 83% respectively (P=0.063ns). CONCLUSION: Sacrocolpopexy offers good anatomical results, with better objective and subjective success rates when associated with a subtotal hysterectomy. The decision of hysterectomy should consider the risk/benefit balance and the patient's preferences.
Disciplines :
Reproductive medicine (gynecology, andrology, obstetrics)
Author, co-author :
Saliba, E.
Nisolle, Michelle ; Université de Liège - ULiège > Département des sciences cliniques > Gynécologie - Obstétrique
Tchente, C.
DE LANDSHEERE, Laurent ; Université de Liège - ULiège > Département des sciences cliniques > Gynécologie - Obstétrique
Language :
French
Title :
Doit-on realiser systematiquement une hysterectomie subtotale dans le cadre d'une promontofixation coelioscopique ?
Alternative titles :
[en] Do we need to perform systematic supracervical hysterectomy during laparoscopic sacrocolpopexy?
Publication date :
2019
Journal title :
Gynécologie, Obstétrique, Fertilité et Sénologie
ISSN :
2468-7197
eISSN :
2468-7189
Publisher :
Elsevier Masson, Issy-les-Moulineaux, France
Peer reviewed :
Peer Reviewed verified by ORBi
Commentary :
Copyright (c) 2019 Elsevier Masson SAS. All rights reserved.
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