Sacrocolpopexy with Concomitant Total vs Supracervical Hysterectomy: Functional Support Comparisons in Cadavers

Pedro Antonio Maldonado, Kyle P. Norris, Maria E. Florian-Rodriguez, Nemi M. Shah, Clifford Y. Wai

Research output: Contribution to journalArticle

Abstract

This study aimed to compare the ability of abdominal sacrocolpopexy (ASC) with concomitant total vs supracervical hysterectomy to resist downward traction as a measure of functional anatomic support in human cadavers. Methods Supracervical hysterectomy was performed on unembalmed cadaver specimens, followed by ASC attaching polypropylene mesh to the posterior cervix/vagina only and then the anterior and posterior cervix/vagina. Using a metal bolt placed through the cervix tied to a filament passing through a fixed pulley system, successive weights of 0.5 to 3.0 kg were added to provide increasing loads on the apex (cervix), and the distances traversed by the apex were recorded. The same process was then repeated in each specimen after removal of the cervix (with vaginal cuff closure). One-way and repeated-measures analysis of measure was used for between-group and within-group comparisons, respectively, with P ≤ 0.05 considered statistically significant. Results Eight cadavers were examined. At lower weight loads, pulling distances in the 4 groups examined were similar and were not significantly different with the presence or absence of the cervix. At weight loads of 2.5 kg or greater, we noted a trend of increased pulling distances when posterior mesh only was used vs when anterior/posterior mesh was placed, although this difference was not significant. Interestingly, there was tearing of the vaginal wall or partial separation of mesh/sutures attachments to the vagina noted in 3 specimens. Conclusions This study showed no differences in the ability of the cervix (after supracervical hysterectomy) compared with the vaginal cuff (after total hysterectomy) to resist downward traction of successive weights after ASC. Clinical trials are necessary to correlate these findings with prolapse recurrence rates and patient satisfaction following these procedures.

Original languageEnglish (US)
Pages (from-to)213-217
Number of pages5
JournalFemale Pelvic Medicine and Reconstructive Surgery
Volume25
Issue number3
DOIs
StatePublished - May 1 2019

Fingerprint

Hysterectomy
Cadaver
Cervix Uteri
Vagina
Weights and Measures
Traction
Polypropylenes
Prolapse
Patient Satisfaction
Sutures
Metals
Clinical Trials
Recurrence

Keywords

  • posterior mesh
  • sacrocolpopexy
  • supracervical hysterectomy
  • total hysterectomy

ASJC Scopus subject areas

  • Surgery
  • Obstetrics and Gynecology
  • Urology

Cite this

Sacrocolpopexy with Concomitant Total vs Supracervical Hysterectomy : Functional Support Comparisons in Cadavers. / Maldonado, Pedro Antonio; Norris, Kyle P.; Florian-Rodriguez, Maria E.; Shah, Nemi M.; Wai, Clifford Y.

In: Female Pelvic Medicine and Reconstructive Surgery, Vol. 25, No. 3, 01.05.2019, p. 213-217.

Research output: Contribution to journalArticle

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