Native-tissue prolapse repair: Efficacy and adverse effects of uterosacral ligaments suspension at 10-year follow up

Objective To evaluate the 10-year outcomes of high uterosacral ligaments suspension as a primary repair for apical prolapse and to evaluate the long-term impact of prognostic factors. Methods A retrospective study analyzed 10-year follow up after repair of primary apical prolapse through high uterosacral ligament suspension. Bulging symptoms and postoperative prolapse stage II or above were considered subjective and objective recurrences, respectively. Patient Global Impression of Improvement score was used to evaluate subjective satisfaction after surgery. Results A total of 287 women were analyzed. Ten-year recurrence rates were 19.1% for objective recurrence and 6.3% for subjective recurrence; surgical retreatment rate was 2.1%. Premenopausal status was related to 15-fold increased risk of developing either objective or subjective recurrence. Conversely, anterior and posterior repair were protective factors against reoperation. Conclusion High uterosacral ligaments suspension is a safe and long-lasting effective procedure for the treatment of uterovaginal prolapse even 10 years after index surgery. Premenopausal status and lack of anterior and posterior repair represented long-term risk factors for surgical failure.