Long-term outcomes of modified high uterosacral ligament vault suspension (HUSLS) at vaginal hysterectomy

• Published in: International Urogynecology Journal Vol. 22; no. 5; pp. 577 - 584
• Main Authors: Doumouchtsis, Stergios K., Khunda, Azar, Jeffery, Stephen T., Franco, Anna Virginia M., Fynes, Michelle M.
• Format: Journal Article
• Language: English
• Published: London Springer-Verlag 01-05-2011; Springer Nature B.V
• Subjects: Aged; Aged, 80 and over; Female; Follow-Up Studies; Gynecology; Humans; Hysterectomy, Vaginal - methods; Ligaments - surgery; Medicine; Medicine & Public Health; Middle Aged; Original Article; Patient Satisfaction; Pelvic Organ Prolapse - surgery; Prospective Studies; Quality of Life; Retrospective Studies; Sexual Behavior; Surveys and Questionnaires; Time Factors; Treatment Outcome; Urology; Uterosacral ligament suspension; Long-term outcomes; Vaginal hysterectomy; Vaginal vault prolapse; Vault suspension
• ISSN: 0937-3462; 1433-3023
• DOI: 10.1007/s00192-010-1325-8

Introduction and hypothesis
The aim of this study was to prospectively evaluate long-term outcomes of a modified high uterosacral ligament suspension (HUSLS) at vaginal hysterectomy for pelvic organ prolapse (POP).
Methods
POP was assessed 5 years postoperatively in 42 women who underwent vaginal hysterectomy and HUSLS for POP. Bladder, bowel, sexual function and quality of life (QoL) were evaluated.
Results
Preoperatively, 27/42 women had at least BW grade 2 uterine prolapse. At a mean follow-up period of 59.4 months (range: 40–79 months), two women had undergone surgical intervention for vault prolapse, 33 had no vault prolapse and six grade 1 vault prolapse. One woman declined vaginal examination. Twenty women were sexually active and 18 completed the PISQ-31. The mean total score for all domains was 91/125. On QoL assessments high scores were noted in all domains.
Conclusions
Modified HUSLS at vaginal hysterectomy is associated with satisfactory long-term objective and subjective outcomes, sexual function and quality of life scores.