Sacrospinous hysteropexy: review and meta-analysis of outcomes

Kapoor, Shveta, Sivanesan, Kanapathippillai, Robertson, Jessica Amy, Veerasingham, Mayooran and Kapoor, Vishal (2017) Sacrospinous hysteropexy: review and meta-analysis of outcomes. International Urogynecology Journal, 1-10. doi:10.1007/s00192-017-3291-x

Author Kapoor, Shveta
Sivanesan, Kanapathippillai
Robertson, Jessica Amy
Veerasingham, Mayooran
Kapoor, Vishal
Title Sacrospinous hysteropexy: review and meta-analysis of outcomes
Journal name International Urogynecology Journal   Check publisher's open access policy
ISSN 1433-3023
Publication date 2017-03-01
Sub-type Article (original research)
DOI 10.1007/s00192-017-3291-x
Open Access Status Not yet assessed
Start page 1
End page 10
Total pages 10
Place of publication London, United Kingdom
Publisher Springer U K
Language eng
Formatted abstract
Introduction: Sacrospinous hysteropexy is a uterine-preserving procedure for treatment of apical prolapse. We present a literature review evaluating the sacrospinous hysteropexy procedure and its current place in the surgical management of pelvic organ prolapse. Additionally, to assess the efficacy of the procedure, we performed a meta-analysis of studies comparing sacrospinous hysteropexy to vaginal hysterectomy and repair in terms of anatomical outcomes, complications, and repeat surgery.

Methods: Major literature databases including MEDLINE (1946 to 2 April 2016), Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 3), and Embase (1947 to 2 April 2016) were searched for relevant studies. We used Cochrane Collaboration’s Review Manager software to perform meta-analysis of randomized controlled studies and observational studies.

Results: Vaginal sacrospinous hysteropexy was first performed in 1989 and is similar in technique to sacrospinous colpopexy. Two randomized controlled trials and four cohort studies (n = 651) were included in the meta-analysis. Apical failure rates after sacrospinous hysteropexy versus vaginal hysterectomy were not significantly different, although the trend favored vaginal hysterectomy [odds ratio (OR) 2.08; 95% confidence interval (CI) 0.76–5.68]. Rates of repeat surgery for prolapse were not significantly different between the two groups (OR 0.99; 95% CI 0.41–2.37). The most significant disadvantage of uterine-preservation prolapse surgery when compared with hysterectomy is the lack of prevention and diagnosis of uterine malignancy.

Conclusion: Sacrospinous hysteropexy is a safe and effective procedure for pelvic organ prolapse and has comparable outcomes to vaginal hysterectomy with repair.
Keyword Apical prolapse
Sacrospinous hysteropexy
Uterine preservation
Vaginal hysterectomy
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
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