American Journal of Obstetrics & Gynecology
Volume 202, Issue 2 , Pages 124-134, February 2010

Outcomes of transvaginal uterosacral ligament suspension: systematic review and metaanalysis

  • Rebecca U. Margulies, MD

      Affiliations

    • Pelvic Floor Research Group, University of Michigan, Ann Arbor, MI
    • Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI
    • ,
  • Mary A.M. Rogers, PhD, MS

      Affiliations

    • Department of Internal Medicine, University of Michigan, Ann Arbor, MI
    • ,
  • Daniel M. Morgan, MD

      Affiliations

    • Pelvic Floor Research Group, University of Michigan, Ann Arbor, MI
    • Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI

Received 19 May 2009; received in revised form 6 July 2009; accepted 20 July 2009.

This systematic review of uterosacral ligament suspension provides a metaanalysis of anatomic outcomes and a summary of subjective outcomes. A successful anatomic outcome was considered present when women had “optimal” or “satisfactory” (pelvic organ prolapse quantification system stage 0 or 1) outcomes. In the anterior, apical, and posterior compartments, the pooled rates for a successful outcome were 81.2% (95% confidence interval [CI], 67.5–94.5%), 98.3% (95% CI, 95.7–100%), and 87.4% (95% CI, 67.5–94.5%). In the anterior compartment, women with preoperative stage 2 prolapse were more likely than those with preoperative stage 3 prolapse to have a successful anatomic outcome (92.4% vs 66.8%; P = .06). Outcomes, with respect to subjective symptoms, were reassuring; however, it was not possible to pool data because of methodologic differences between studies.

Key words: culdeplasty, pelvic organ prolapse, surgery, treatment outcome, uterosacral ligament suspension

 

 Authorship and contribution to the article is limited to the 3 authors indicated. There was no outside funding or technical assistance with the production of this article.

 Reprints not available from the authors.

PII: S0002-9378(09)00838-2

doi:10.1016/j.ajog.2009.07.052

American Journal of Obstetrics & Gynecology
Volume 202, Issue 2 , Pages 124-134, February 2010