Clinical and Experimental Obstetrics & Gynecology (CEOG) is published by IMR Press from Volume 47 Issue 1 (2020). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.
†Contributed equally.
Purpose of Investigation: High uterosacral ligament suspension (USLS) performed after vaginal hysterectomy is a popular technique for apical vaginal suspension. This technique was originally described using three stitches on each ligament. The aim of this study was to determine anatomical and clinical cure rates, as well as patient satisfaction after transvaginal hysterectomy and two-stitch uterosacral ligament suspension. Materials and Methods: A retrospective cohort study including all patients who underwent transvaginal hysterectomy and two-stitch USLS between January 2012 and December 2014. Preoperative as well as postoperative clinical data was gathered including POP-Q measurements of prolapse. Primary outcomes were anatomical cure defined as no POP-Q point above stage 1 and clinical cure defined as a composite of no prolapse symptoms, no prolapse beyond the hymen, and no need for treatment of prolapse. Patient satisfaction was evaluated using the Patient Global Impression of Improvement (PGI-I) questionnaire validated in the Hebrew language for this study. Statistical analyses included univariate and logistic regression methods. Results: Eighty-two women underwent vaginal hysterectomy and USLS during the study period. Follow up data were available for 66 women. At a median follow-up of 14.5 months, all relevant POP-Q measures were significantly improved compared to preoperatively. Anatomical cure was 87.8% and clinical cure rate was 95.4%. Patient satisfaction was high at 100%, stating that their prolapse symptoms were much better or exceptionally better postoperatively. Conclusion: Transvaginal hysterectomy and two-stitch uterosacral ligament suspension has high cure and patient satisfaction rates.