High Midline Levator Myorrhaphy for Vaginal Vault Prolapse: Long-Term Results

Date

2016-01-19

Authors

Wu, Yuefeng (Rose)

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Abstract

INTRODUCTION AND OBJECTIVE: To review long-term outcomes following a vaginal native tissue repair (High Midline Levator Myorrhaphy, HMLM) in women with symptomatic vault prolapse.1, 2 METHODS: Following IRB-approval, a prospectively maintained database of women who underwent HMLM for symptomatic vault prolapse (VP) alone or associated with other POP was reviewed for demographic data, history of prior POP, physical examination, hospital stay length, and long-term outcomes. Patients with <6 months follow up and no retrievable operative notes were excluded. Data was reviewed by a third party investigator not involved in patient care. Failure was defined as same compartment POP ≥ stage 2 or POP reoperation. Descriptive statistics and Kaplan-Meier curves were obtained. RESULTS: Between 1996 and 2014, 94 women who underwent HMLM were studied. Mean follow-up time was 7.7 (0.6-18.4) years, mean age was 69.6 (36-91), and 89% were Caucasian. Patients were grouped by POP indications: VP (6), vault and anterior (26), vault and posterior (35), and all 3 compartments (27) (Table 1). No intra-operative complications were reported. Ten (11%) early complications (<30 days) were noted (Clavien I/II). Sixty-seven (71%) women were cured of VP. Ten women (11%) had failure in a non-apical compartment and 17 (18%) had apical failure. Reoperation rate was 14% (13/94) and 5% (5/94) for vault and non-vault recurrences, respectively. VP recurrence-free probability between women with ≤ 2 versus 3 POP compartments was statistically significant (p = 0.0128). CONCLUSIONS: At a mean follow-up of 7-8 years, HMLM was successful in two thirds of women. Best outcome was noted in women with VP and one associated compartment prolapse. REFERENCES: 1. Lemack, G. E., et al. Urology, 56: 50, 2000. 2. Natale, F. et al. J Urol, 180: 2047, 2008

General Notes

The 54th Annual Medical Student Research Forum at UT Southwestern Medical Center (Monday, January 19, 2016, 2-5 p.m., D1.700)

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Citation

Wu, Y. (Rose), Christie, A., Alhalabi, F., & Zimmern, P. E. (2016, January 19). High midline levator myorrhaphy for vaginal vault prolapse: long-term results. Poster presented at the 54th Annual Medical Student Research Forum, Dallas, TX. Retrieved from https://hdl.handle.net/2152.5/3295.

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