Subjective prolapse symptoms after Total Laparoscopic Hysterectomy compared toLaparoscopic Supracervical Hysterectomy

Siemons, S.E. (2016) Subjective prolapse symptoms after Total Laparoscopic Hysterectomy compared toLaparoscopic Supracervical Hysterectomy. thesis, Medicine.

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Abstract

Background: Hysterectomy is one of the most frequently performed gynaecological procedures and a risk factor for developing Pelvic Organ Prolapse (POP). Currently, it is unclear whether there is a difference in development of POP after Total Laparoscopic Hysterectomy (TLH) and Laparoscopic Supracervical Hysterectomy (LASH). Because a LASH conserves the cervix, cardinal and uterosacral ligaments and a TLH does not, we hypothesized that the risk of developing POP is less after LASH than after TLH. Objective: To compare subjective prolapse symptoms after TLH and LASH. Methods: A prospective, observational study of 219 women who underwent TLH or LASH at our institution was performed, between 2008 and 2014. All eligible women received a validated questionnaire regarding urogenital-, gastrointestinal- and sexual symptoms. A Mann-Whitney U test was used for continuous variables and a Chi-square or Fisher’s exact test for categorical variables. Significant outcomes were corrected for confounders using logistic regression. Results: Baseline characteristics of both groups were similar, except for age, time from hysterectomy to start study and indications. The most common indication for TLH was malignancy and for LASH myoma. Significantly less women in the LASH group reported symptoms of obstructive defecation (p= 0.05) and significantly more women in the LASH group were sexually active (p= 0.015) compared to the TLH group. Conclusion Less women reported symptoms of obstructive defecation and more women were sexually active after LASH compared to TLH. Further advantages of LASH over TLH regarding subjective prolapse symptoms could not be detected. However, results must be interpreted cautiously because of possible confounding due to inclusion of women with a malignant indication for hysterectomy.

Item Type:	Thesis (Thesis)
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:58
Last Modified:	25 Jun 2020 10:58
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1858

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