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Surgical outcomes in patients aged 70 years and older following uterosacral ligament suspension: a comparative study.
Chill, Henry H; Dick, Aharon; Cohen, Adiel; Ryvkin, Ina; Rosenbloom, Joshua I; Reuveni-Salzman, Adi; Shveiky, David.
Afiliação
  • Chill HH; Division of Urogynecology, University of Chicago Pritzker School of Medicine, NorthShore University HealthSystem, Skokie, IL, USA. henchill@gmail.com.
  • Dick A; Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel.
  • Cohen A; Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel.
  • Ryvkin I; Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel.
  • Rosenbloom JI; Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel.
  • Reuveni-Salzman A; Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel.
  • Shveiky D; Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel.
Arch Gynecol Obstet ; 307(6): 2033-2040, 2023 06.
Article em En | MEDLINE | ID: mdl-36840767
ABSTRACT

PURPOSE:

The number of elderly patients bothered by pelvic organ prolapse symptoms is growing rapidly. The aim of this study was to evaluate the relationship between age and surgical outcomes in women undergoing uterosacral ligament suspension for treatment of apical prolapse.

METHODS:

We performed a retrospective cohort study including women who underwent uterosacral ligament suspension between 2010 and 2020. The cohort was divided into two groups (1) Patients 70 years or older; (2) Patients under the age of 70. Outcome measures included clinical, anatomical, and composite outcomes as well as patient satisfaction.

RESULTS:

A total of 271 patients were included in the final analysis. Of them 209 patients were under age 70 and 62 patients 70 years or older. Mean age was 59 ± 6 vs. 73 ± 3 for the young and elderly age groups, respectively. Clinical success was high for both groups, reaching 94% vs. 89% for elderly and young patients, respectively (p = 0.34). Anatomical and composite outcome success were higher in the young age group (76% vs. 56%, p < 0.01 and 70% vs. 54%, p = 0.02, respectively); however, following multivariate analysis these differences were no longer statistically significant. Following multivariate logistic regression analysis for the dependent parameter of anatomical success, increased pre-operative genital hiatus and vaginal surgical route were associated with anatomical failure while performing a concomitant posterior colporrhaphy increased likelihood for anatomical success.

CONCLUSION:

Women over the age of 70 undergoing uterosacral ligament suspension for treatment of apical prolapse have comparable outcomes to younger patients.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Procedimentos Cirúrgicos em Ginecologia / Prolapso de Órgão Pélvico Tipo de estudo: Etiology_studies / Observational_studies / Risk_factors_studies Limite: Aged / Aged80 / Female / Humans / Middle aged Idioma: En Revista: Arch Gynecol Obstet Assunto da revista: GINECOLOGIA / OBSTETRICIA Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Procedimentos Cirúrgicos em Ginecologia / Prolapso de Órgão Pélvico Tipo de estudo: Etiology_studies / Observational_studies / Risk_factors_studies Limite: Aged / Aged80 / Female / Humans / Middle aged Idioma: En Revista: Arch Gynecol Obstet Assunto da revista: GINECOLOGIA / OBSTETRICIA Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Estados Unidos