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Introduction and Hypothesis <p>To assess long-term patient-reported outcomes across six surgical procedures for first-time vaginal vault suspension (VVS) for apical prolapse.</p> Methods <p>A nationwide cohort study with 3–14 years of follow-up. Data were obtained from a national urogynaecological database, medical records, and questionnaires: International Consultation on Incontinence Questionnaire–Vaginal Symptoms (ICIQ-VS), Pelvic Floor Distress Inventory-20 (PFDI-20), Pelvic Floor Impact Questionnaire-7 (PFIQ-7). A total of 1016 women with prior hysterectomy underwent first-time VVS between 2010 and 2020, including sacrocolpopexy (SCP, <i>n</i> = 107), laparoscopic uterosacral ligament suspension (LUSLS, <i>n</i> = 25), ipsilateral uterosacral ligament suspension (IUSLS, <i>n</i> = 284), vaginal extraperitoneal uterosacral ligament suspension (VEULS, <i>n</i> = 56), sacrospinous ligament fixation (SSLF, <i>n</i> = 493), and sacrospinous ligament fixation with graft (SSLF with graft, <i>n</i> = 51). Patients were identified using NOMESCO procedure codes. Multivariable analyses adjusted for age, time since VVS, and prior prolapse surgery. The primary outcome was global impact of vaginal symptoms; secondary outcomes included sexual symptom burden and vaginal, bowel, and urinary symptoms.</p> Results <p>SCP was associated with lower symptom burden than other procedures. Compared with SCP global impact score was higher following IUSLS (ratio 1.30, 95% CI 1.01–1.69) and SSLF (ratio 1.28, 95% CI 1.00–1.64). Sexual symptom burden was higher after SSLF with graft (ratio 4.07, 95% CI 1.19–13.91), and higher PFIQ-7 scores were observed following IUSLS (ratio 1.56, 95% CI 1.07–2.30).</p> Conclusion <p>SCP was associated with lower long-term symptom burden, whereas SSLF with graft and IUSLS were associated with higher symptom burden in selected domains. Findings should be interpreted with caution due to potential confounding.</p>

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Long-Term Comparison of Patient-Reported Outcomes Following Six Surgical Procedures for Apical Suspension

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月9日

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  • Dorte Teilmann-Jørgensen,
  • Niels Klarskov,
  • Ditte Gommesen,
  • Marianne Glavind-Kristensen,
  • Karin Glavind,
  • Martin Rudnicki

摘要

Introduction and Hypothesis

To assess long-term patient-reported outcomes across six surgical procedures for first-time vaginal vault suspension (VVS) for apical prolapse.

Methods

A nationwide cohort study with 3–14 years of follow-up. Data were obtained from a national urogynaecological database, medical records, and questionnaires: International Consultation on Incontinence Questionnaire–Vaginal Symptoms (ICIQ-VS), Pelvic Floor Distress Inventory-20 (PFDI-20), Pelvic Floor Impact Questionnaire-7 (PFIQ-7). A total of 1016 women with prior hysterectomy underwent first-time VVS between 2010 and 2020, including sacrocolpopexy (SCP, n = 107), laparoscopic uterosacral ligament suspension (LUSLS, n = 25), ipsilateral uterosacral ligament suspension (IUSLS, n = 284), vaginal extraperitoneal uterosacral ligament suspension (VEULS, n = 56), sacrospinous ligament fixation (SSLF, n = 493), and sacrospinous ligament fixation with graft (SSLF with graft, n = 51). Patients were identified using NOMESCO procedure codes. Multivariable analyses adjusted for age, time since VVS, and prior prolapse surgery. The primary outcome was global impact of vaginal symptoms; secondary outcomes included sexual symptom burden and vaginal, bowel, and urinary symptoms.

Results

SCP was associated with lower symptom burden than other procedures. Compared with SCP global impact score was higher following IUSLS (ratio 1.30, 95% CI 1.01–1.69) and SSLF (ratio 1.28, 95% CI 1.00–1.64). Sexual symptom burden was higher after SSLF with graft (ratio 4.07, 95% CI 1.19–13.91), and higher PFIQ-7 scores were observed following IUSLS (ratio 1.56, 95% CI 1.07–2.30).

Conclusion

SCP was associated with lower long-term symptom burden, whereas SSLF with graft and IUSLS were associated with higher symptom burden in selected domains. Findings should be interpreted with caution due to potential confounding.