Traditional McCall culdoplasty compared to a modified McCall technique with double ligament suspension: anatomical and clinical outcomes.
McCall culdoplasty
Native tissue repair
Prolapse recurrence
Vaginal suspension
Journal
International urogynecology journal
ISSN: 1433-3023
Titre abrégé: Int Urogynecol J
Pays: England
ID NLM: 101567041
Informations de publication
Date de publication:
10 2020
10 2020
Historique:
received:
23
04
2020
accepted:
17
06
2020
pubmed:
1
7
2020
medline:
24
6
2021
entrez:
29
6
2020
Statut:
ppublish
Résumé
This study compared anatomical and clinical outcomes of traditional McCall culdoplasty versus a modified McCall technique with double ligament suspension (DLS). This retrospective study presents outcomes of 68 patients who underwent vaginal hysterectomy and vaginal suspension for apical prolapse ≥ stage II according to the POP-Q score system, at, between January 2016 and February 2018. In 34 women vaginal cuff suspension was obtained with traditional McCall culdoplasty (McCall group), while in 34 women we performed a modified McCall, which consists of a double ligament suspension (DLS group), suspending the vaginal cuff to uterosacral ligaments and also to adnexal peduncles. Primary outcome was prolapse recurrence ≥ stage II according to the POP-Q system. Fisher's, Mann-Whitney U and Student's t tests were used for statistical analysis. There were no statistical differences among patients' preoperative characteristics, operative time, blood loss or postoperative complications. Follow-up mean duration was 23.2 ± 6.7 and 22.4 ± 8.7 months in the McCall and DLS group, respectively. Prolapse recurrence occurred in 11 (32.3%) women in the McCall group versus 2 (5.9%) women in the DLS group (p < 0.05): among them, 2 patients (5.9%) in the McCall group and 1 (2.9%) in the DLS group required further treatment. Total vaginal length was 6.1 ± 0.9 cm in the McCall group versus 6.9 ± 0.7 cm in the DLS group (p < 0.001). No statistical difference in quality of life assessment was observed. DLS group patients had better anatomical outcomes and lower recurrence rates than McCall group patients, without increasing operative time or complications. A prospective study with more cases is needed to confirm our data.
Identifiants
pubmed: 32594190
doi: 10.1007/s00192-020-04403-4
pii: 10.1007/s00192-020-04403-4
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2147-2153Références
Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn. 2010;29(1):4–20.
doi: 10.1002/nau.20798
Khunda A, Vashisht A, Cutner A. New procedures for uterine prolapse. Best Pract Res Clin Obstet Gynaecol. 2013;27(3):363–79.
doi: 10.1016/j.bpobgyn.2012.12.004
Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL. Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol. 1997;89:501–6.
doi: 10.1016/S0029-7844(97)00058-6
Fialkow MF, Newton KM, Lentz GM, Weiss NS. Lifetime risk of surgical management for pelvic organ prolapse or urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct. 2008;19:437–40.
doi: 10.1007/s00192-007-0459-9
Subak LL, Waetjen LE, van den Eeden S, Thom DH, Vittinghoff E, Brown JS. Cost of pel- Vic organ prolapse surgery in the United States. Obstet Gynecol. 2001;98:646–51.
pubmed: 11576582
Oversand SH, Staff AC, Spydslaug AE, Svennings S, Borstad E. Long-term follow-up after native tissue repair for pelvic organ prolapse. Int Urgynecol J. 2014;25:81–9.
doi: 10.1007/s00192-013-2166-z
Price N, Slack A, Jwarah E, Jackson S. The incidence of reoperation for surgically treated pelvic organ prolapse: an 11-year experience. Menopause Int. 2008;14(4):145–8.
doi: 10.1258/mi.2008.008029
Jha S, Moran P. The UK national prolapse survey: 5 years on. Int Urogynecol J. 2011;22(5):517–28.
doi: 10.1007/s00192-011-1379-2
Vanspauwen R, Seman E, Dwyer P. Survey of current management of prolapse in Australia and New Zealand. Aust N Z J Obstet Gynaecol. 2010;50(3):262–7.
doi: 10.1111/j.1479-828X.2010.01145.x
Cheon C, Maher C. Economics of pelvic organ prolapse surgery. Int Urogynecol J. 2013;24(11):1873–6.
doi: 10.1007/s00192-013-2178-8
Milani R, Salvatore S, Soligo M, Pifarotti P, Meschia M, Cortese M. Functional and anatomical outcome of anterior and posterior vaginal prolapse repair with prolene mesh. BJOG. 2005;112:107–11.
doi: 10.1111/j.1471-0528.2004.00332.x
Julian TM. The efficacy of Marlex mesh in the repair of severe, recurrent vaginal prolapse of the anterior midvaginal wall. Am J Obstet Gynecol. 1996;186:1472–5.
doi: 10.1016/S0002-9378(96)70092-3
Novara L, Sgro LG, Pecchio S, Ottino L, Tomatis V. Biglia N. Transvaginal high uterosacral ligament suspension: an alternative to McCall culdoplasty in the treatment of pelvic organ prolapse. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2019;240:278–81. https://doi.org/10.1016/j.ejogrb.2019.07.007 .
doi: 10.1016/j.ejogrb.2019.07.007
Margulies RU, Rogers MA, Morgan DM. Outcomes of transvaginal uterosacral ligament suspension: systematic review and metaanalysis. Am J Obstet Gynecol. 2010 Feb;202(2):124–34. https://doi.org/10.1016/j.ajog.2009.07.052 .
doi: 10.1016/j.ajog.2009.07.052
pubmed: 20113690
Spelzini F, Frigerio M, Manodoro S, Interdonato ML, Cesana MC, Verri D, et al. Modified McCall culdoplasty versus Shull suspension in pelvic prolapse primary repair: a retrospective study. Int Urogynecol J. 2017;28(1):65–71.
doi: 10.1007/s00192-016-3016-6
Schiavi MC, Savone D, Di Mascio D, Di Tucci C, Perniola G, Zullo MA, et al. Long-term experience of vaginal vault prolapse prevention at hysterectomy time by modified McCall culdoplasty or Shull suspension: clinical, sexual and quality of life assessment after surgical intervention. Eur J Obstet Gynecol Reprod Biol. 2018;223:113–8. https://doi.org/10.1016/j.ejogrb.2018.02.025 .
doi: 10.1016/j.ejogrb.2018.02.025
pubmed: 29518641
Bump RC, Mattiasson A, Bø K, Brubaker LP, DeLancey JO, Klarskov P, et al. The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol. 1996;175:10–7.
doi: 10.1016/S0002-9378(96)70243-0
McCall ML. Posterior culdeplasty; surgical correction of enterocele during vaginal hysterectomy; a preliminary report. Obstet Gynecol. 1957;10:595–602.
doi: 10.1097/00006250-195712000-00001
Barber MD, Walters MD, Bump RC. Short forms of two condition-specific quality-of-life questionnaires for women with pelvic floor disorders (PFDI-20 and PFIQ-7). Am J Obstet Gynecol. 2005;193:103–13.
doi: 10.1016/j.ajog.2004.12.025
Yazdany T, Bhatia N. Uterosacral ligament vaginal vault suspension: anatomy, outcome and surgical considerations. Curr Opin Obstet Gynecol. 2008;20(5):484–8.
doi: 10.1097/GCO.0b013e32830eb8c6
Silva WA, Pauls RN, Segal JL, et al. Uterosacral ligament vault suspension: five-year outcomes. Obstet Gynecol. 2006;108:255–63.
doi: 10.1097/01.AOG.0000224610.83158.23
Baden WF, Walker T. Surgical repair of vaginal defects. Philadelphia: The Lippincott Company Ed.; 1992.
Cosma S, Petruzzelli P, Chiadò Fiorio Tin M, Parisi S, Olearo E, Fassio F, Zizzo R, Danese S, Benedetto C. Simplified laparoscopic sacropexy avoiding deep vaginal dissection. Int J Gynaecol Obstet 2018;143(2):239–245. https://doi.org/10.1002/ijgo.12632 .
Deo G, Bernasconi DP, Cola A, Palmieri S, Spelzini F, Milani R, et al. Long-term outcomes and five-year recurrence-free survival curves after native-tissue prolapse repair. Int J Gynaecol Obstet. 2019;147:238–45.
doi: 10.1002/ijgo.12938
Manodoro S, Frigerio M, Milani R, Spelzini F. Tips and tricks for uterosacral ligament suspension: how to avoid ureteral injury. Int Urogynecol J. 2018;29:161–3.
doi: 10.1007/s00192-017-3497-y
Schulten SFM, Detollenaere RJ, Stekelenburg J, IntHout J, Kluivers KB, van Eijndhoven HWF. Sacrospinous hysteropexy versus vaginal hysterectomy with uterosacral ligament suspension in women with uterine prolapse stage 2 or higher: observational follow-up of a multicentre randomised trial. BMJ. 2019;366:l5149. https://doi.org/10.1136/bmj.l5149 .
doi: 10.1136/bmj.l5149
pubmed: 31506252
pmcid: 6734519
Morgan DM, Rogers MA, Huebner M, Wei JT, Delancey JO. Heterogeneity in anatomic outcome of sacrospinous ligament fixation for prolapse: a systematic review. Obstet Gynecol. 2007;109:1424–33.
doi: 10.1097/01.AOG.0000264066.89094.21