Vaginal McCall culdoplasty versus laparoscopic uterosacral plication to prophylactically address vaginal vault prolapse

Kathy Niblock, Emily Bailie, Geoff McCracken, Keith Johnston

Research output: Contribution to journalArticle

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61 Downloads (Pure)

Abstract

BACKGROUND: Studies have shown that vaginal vault prolapse can affect up to 43% of women following hysterectomy for pelvic organ prolapse. Many techniques have been described to prevent and treat vaginal vault prolapse. The primary objective of our study was to compare McCall's culdoplasty (when performed along side vaginal hysterectomy) with laparoscopic uterosacral plication (when performed along side total laparoscopic hysterectomy) for prevention of vaginal vault prolapse. Secondary outcomes included inpatient stay and perioperative complications. A retrospective comparison study comparing 73 patients who underwent 'laparoscopic hysterectomy and uterosacral plication' against 70 patients who underwent 'vaginal hysterectomy and McCall culdoplasty'. All operations were carried out by two trained surgeons.

RESULTS: There was no significant difference between BMI or parity. There were statistically significantly more patients presenting with post hysterectomy vault prolapse (PHVP) in the group of patients who had undergone uterosacral plication (12 out of 73) compared with McCalls culdoplasty (0 out of 70) P = 0.000394. Inpatient stay in the uterosacral plication group was significantly shorter mean 1.8 compared to 3.6 for McCall group (P-Value is <0.00001). There was no significance in the perioperative complications between both groups (P = 0.41).

CONCLUSIONS: McCalls is a superior operation to prevent PHVP compared to uterosacral plication with no difference in terms of perioperative complications.

Original languageEnglish
Number of pages6
JournalGynecological surgery
Volume14
Issue number3
DOIs
Publication statusPublished - 12 Apr 2017
Externally publishedYes

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Pelvic Organ Prolapse
Hysterectomy
Vaginal Hysterectomy
Prolapse
Inpatients
Parity
Retrospective Studies

Keywords

  • Journal Article

Cite this

Niblock, Kathy ; Bailie, Emily ; McCracken, Geoff ; Johnston, Keith. / Vaginal McCall culdoplasty versus laparoscopic uterosacral plication to prophylactically address vaginal vault prolapse. In: Gynecological surgery. 2017 ; Vol. 14, No. 3.
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Vaginal McCall culdoplasty versus laparoscopic uterosacral plication to prophylactically address vaginal vault prolapse. / Niblock, Kathy; Bailie, Emily; McCracken, Geoff; Johnston, Keith.

In: Gynecological surgery, Vol. 14, No. 3, 12.04.2017.

Research output: Contribution to journalArticle

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N2 - BACKGROUND: Studies have shown that vaginal vault prolapse can affect up to 43% of women following hysterectomy for pelvic organ prolapse. Many techniques have been described to prevent and treat vaginal vault prolapse. The primary objective of our study was to compare McCall's culdoplasty (when performed along side vaginal hysterectomy) with laparoscopic uterosacral plication (when performed along side total laparoscopic hysterectomy) for prevention of vaginal vault prolapse. Secondary outcomes included inpatient stay and perioperative complications. A retrospective comparison study comparing 73 patients who underwent 'laparoscopic hysterectomy and uterosacral plication' against 70 patients who underwent 'vaginal hysterectomy and McCall culdoplasty'. All operations were carried out by two trained surgeons.RESULTS: There was no significant difference between BMI or parity. There were statistically significantly more patients presenting with post hysterectomy vault prolapse (PHVP) in the group of patients who had undergone uterosacral plication (12 out of 73) compared with McCalls culdoplasty (0 out of 70) P = 0.000394. Inpatient stay in the uterosacral plication group was significantly shorter mean 1.8 compared to 3.6 for McCall group (P-Value is <0.00001). There was no significance in the perioperative complications between both groups (P = 0.41).CONCLUSIONS: McCalls is a superior operation to prevent PHVP compared to uterosacral plication with no difference in terms of perioperative complications.

AB - BACKGROUND: Studies have shown that vaginal vault prolapse can affect up to 43% of women following hysterectomy for pelvic organ prolapse. Many techniques have been described to prevent and treat vaginal vault prolapse. The primary objective of our study was to compare McCall's culdoplasty (when performed along side vaginal hysterectomy) with laparoscopic uterosacral plication (when performed along side total laparoscopic hysterectomy) for prevention of vaginal vault prolapse. Secondary outcomes included inpatient stay and perioperative complications. A retrospective comparison study comparing 73 patients who underwent 'laparoscopic hysterectomy and uterosacral plication' against 70 patients who underwent 'vaginal hysterectomy and McCall culdoplasty'. All operations were carried out by two trained surgeons.RESULTS: There was no significant difference between BMI or parity. There were statistically significantly more patients presenting with post hysterectomy vault prolapse (PHVP) in the group of patients who had undergone uterosacral plication (12 out of 73) compared with McCalls culdoplasty (0 out of 70) P = 0.000394. Inpatient stay in the uterosacral plication group was significantly shorter mean 1.8 compared to 3.6 for McCall group (P-Value is <0.00001). There was no significance in the perioperative complications between both groups (P = 0.41).CONCLUSIONS: McCalls is a superior operation to prevent PHVP compared to uterosacral plication with no difference in terms of perioperative complications.

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