Evaluation of Sacrospinous Hysteropexy vs. Uterosacral Suspension for the Treatment of Uterine Prolapse: A Retrospective Assessment.

OBJECTIVE: This single-center retrospective study aimed to compare the outcomes of vaginal hysterectomy with utero-sacral suspension (VH/USS) versus sacro-spinous hysteropexy (SSHP) in the management of uterine prolapse at a tertiary care center specializing in Urogynecology. METHODS: The medical records of 50 women with stage 2 or more uterine prolapse treated with VH/USS (n = 26) or SSHP (n = 24) were assessed between January 2006 and December 2012. RESULTS: There were no significant differences between the two groups in terms of body mass index (BMI) and parity P = 0.881 and 0.304, respectively. VH/USS procedure was significantly more successful than SSHP procedure with regard to anatomical success (84.62 vs. 41.67%, P = 0.0028). There was a significantly higher anterior prolapse recurrence with SSHP procedure than with VH/USS (33.3 vs. 7.7%; P = 0.034). SSHP was associated with the lower likelihood of anatomical success and a higher risk of recurrent anterior prolapse in multivariate logistic regression analyzes adjusting for potential confounders. CONCLUSION: The findings of this retrospective study indicate that SSHP appears to be associated with less anatomical objective success and an increased risk of recurrent anterior prolapse in comparison to VH/USS. Further validation of our observations by independent investigators is required.

Accuracy of bladder scanning in the assessment of postvoid residual volume.

OBJECTIVE: To compare the accuracy of the 3D portable ultrasound with catheterization in the assessment of postvoid residual (PVR) urine volume among women in the urogynaecology clinic. METHODS: A prospective study was performed, assessing 101 women. After the patient voided four ultrasound (US) assessments were carried out using the BladderScan BVI 3000; the patient was then catheterized. The reproducibility of the US measurements and the difference between the two methods were assessed using Bland and Altman plots. The strength of the relationship was measured by a simple Pearson correlation coefficient. RESULTS: The results showed that 3D scanner measurements were highly reproducible and were also found to correlate significantly with catheterized volume (r=0.79, 95% CI 0.70-0.85, P<0.001). The mean difference between the two methods was 12.9 mL (95% CI 5.5-20.2 mL, P<0.001). CONCLUSION: In determining PVR volumes, the portable ultrasound BladderScan BVI 3000 is an accurate alternative to bladder catheterization.