No evidence of association between native tissue vault suspension and risk of pelvic pain or sexual dysfunction. (June 2018)

• Record Type: Journal Article
• Authors: Bonde, Lisbeth; Püschl, Ida C.; Møller, Lars Alling; Ottesen, Bent; Breinegaard, Nina; Gimbel, Helga
• Is Part Of: European journal of obstetrics, gynecology, and reproductive biology. Volume 225(2018)
• Page Start: 141
• Page End: 147
• Publication Date: 2018-06
• Subjects: Hysterectomy -- Benign indication -- Vaginal vault suspension -- Pelvic pain -- Sexual dysfunction; Obstetrics -- Periodicals; Gynecology -- Periodicals; Reproductive health -- Periodicals; Gynecology -- Periodicals; Obstetrics -- Periodicals; Reproduction -- Periodicals; Obstétrique -- Périodiques; Gynécologie -- Périodiques; Reproduction -- Périodiques; Verloskunde; Gynaecologie; Voortplanting (biologie); Gynecology; Obstetrics; Reproduction; Electronic journals; Periodicals; Electronic journals; 618.05
• DOI: 10.1016/j.ejogrb.2018.04.022
• Languages: English
• ISSNs: 0301-2115

Abstract

Abstract: Objective: Hysterectomy is suspected of increasing risk of subsequent pelvic organ prolapse (POP). In attempt to prevent this, several suspension methods during hysterectomy on benign indication are used as a prophylactic procedure. However, possible complications to the use of prophylactic vaginal vault suspension to prevent POP are not fully investigated. We aimed to elucidate prophylactic vaginal vault suspension as a possible cause for pelvic pain and sexual dysfunction. Study design: We included all women registered with a total hysterectomy on benign indication and registered with a suspension method or specifically no suspension in the nationwide Danish Hysterectomy and Hysteroscopy Database (DHHD) between 10 May 2012 and 4 September 2013 (N = 3999). A postal questionnaire on pelvic pain and sexual dysfunction was sent to women 25.8 (range 23.8–28.4) months after hysterectomy. Questions were selected from a previous study as well as from the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). We used independent samples t -tests and χ2-tests for univariate analyses. In multivariable analyses, we used log-binomial – and linear regression models adjusted for risk factors of pelvic pain and sexual dysfunction, respectively. Results: The response rate was 60.3% (N = 2412). Of the respondents, 88.8% (N = 2143) were registered with a suspension method and 11.2% (N = 269) were registered with specifically no suspension. Overall, pelvic pain of any kind was reported in 24.3% (N = 576) of the respondents. In adjusted log-binomial regression, suspension did not increase risk of pelvic pain compared to no suspension (RR 0.92; 95% CI 0.75 to 1.14; p -value 0.45). In adjusted linear regression, suspension was significantly associated with less degree of sexual dysfunction (regression coefficient −0.92; 95% CI −1.70 to −0.14; p -value 0.02). Conclusions: In women undergoing prophylactic vaginal vault suspension during hysterectomy, we found less sexual dysfunction and no evidence of increased risk of pelvic pain compared to women with no vaginal vault suspension.