Sensory neuropathy following suspension of the vaginal apex to the proximal uterosacral ligaments

T. Ignacio Montoya, Hillary I. Luebbehusen, Joseph I. Schaffer, Clifford Y. Wai, David D. Rahn, Marlene M. Corton

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Introduction and hypothesis: Reports of sensory neuropathy attributed to uterosacral ligament suspension (USLS) have emerged. The objectives of this study were to assess the rate of sensory neuropathy symptoms following transvaginal USLS at a single institution during a 5-year period and to describe the evaluation, management, and outcomes in these patients. Methods: A retrospective review of records identified 278 women who underwent transvaginal USLS during the study period. Inpatient and outpatient records within the first 4 weeks postsurgery were reviewed. Women with new-onset buttock and/or lower-extremity pain, numbness, weakness or a combination of these symptoms were identified. Demographic data, intraoperative data, and management modalities and outcomes were collected. Results: Nineteen (6.8 %) women met criteria for inclusion. The most common symptom was buttock pain (73.7 % of cases). Pain radiation to the ipsilateral posterior thigh was present in 11 cases (57.9 %). The majority of women (73.7 %) reported pain symptoms on the right side. Conservative treatment modalities were initially implemented in all women. Four women (21 %) underwent suture removal a median of 1.75 months after USLS. Full symptom resolution was reported in 13 (68.4 %) women a median of 6 months after USLS. The remaining women experienced partial symptom resolution with ongoing conservative management. Conclusions: Sensory neuropathy is common in women who undergo transvaginal USLS. As quality of life may be significantly affected, any symptoms of buttock or lower-extremity pain in the immediate postoperative period warrant a thorough evaluation and close follow-up, with early suture removal consideration.

Original languageEnglish (US)
Pages (from-to)1735-1740
Number of pages6
JournalInternational Urogynecology Journal and Pelvic Floor Dysfunction
Volume23
Issue number12
DOIs
StatePublished - Dec 2012

Fingerprint

Ligaments
Suspensions
Buttocks
Pain
Sutures
Lower Extremity
Hypesthesia
Thigh
Postoperative Period
Inpatients
Outpatients
Quality of Life
Demography
Radiation

Keywords

  • Sensory neuropathy
  • Uterosacral ligament suspension

ASJC Scopus subject areas

  • Urology
  • Obstetrics and Gynecology

Cite this

@article{94c3dda2436348409f4d4b2f86565dc3,
title = "Sensory neuropathy following suspension of the vaginal apex to the proximal uterosacral ligaments",
abstract = "Introduction and hypothesis: Reports of sensory neuropathy attributed to uterosacral ligament suspension (USLS) have emerged. The objectives of this study were to assess the rate of sensory neuropathy symptoms following transvaginal USLS at a single institution during a 5-year period and to describe the evaluation, management, and outcomes in these patients. Methods: A retrospective review of records identified 278 women who underwent transvaginal USLS during the study period. Inpatient and outpatient records within the first 4 weeks postsurgery were reviewed. Women with new-onset buttock and/or lower-extremity pain, numbness, weakness or a combination of these symptoms were identified. Demographic data, intraoperative data, and management modalities and outcomes were collected. Results: Nineteen (6.8 {\%}) women met criteria for inclusion. The most common symptom was buttock pain (73.7 {\%} of cases). Pain radiation to the ipsilateral posterior thigh was present in 11 cases (57.9 {\%}). The majority of women (73.7 {\%}) reported pain symptoms on the right side. Conservative treatment modalities were initially implemented in all women. Four women (21 {\%}) underwent suture removal a median of 1.75 months after USLS. Full symptom resolution was reported in 13 (68.4 {\%}) women a median of 6 months after USLS. The remaining women experienced partial symptom resolution with ongoing conservative management. Conclusions: Sensory neuropathy is common in women who undergo transvaginal USLS. As quality of life may be significantly affected, any symptoms of buttock or lower-extremity pain in the immediate postoperative period warrant a thorough evaluation and close follow-up, with early suture removal consideration.",
keywords = "Sensory neuropathy, Uterosacral ligament suspension",
author = "Montoya, {T. Ignacio} and Luebbehusen, {Hillary I.} and Schaffer, {Joseph I.} and Wai, {Clifford Y.} and Rahn, {David D.} and Corton, {Marlene M.}",
year = "2012",
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doi = "10.1007/s00192-012-1810-3",
language = "English (US)",
volume = "23",
pages = "1735--1740",
journal = "International Urogynecology Journal and Pelvic Floor Dysfunction",
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TY - JOUR

T1 - Sensory neuropathy following suspension of the vaginal apex to the proximal uterosacral ligaments

AU - Montoya, T. Ignacio

AU - Luebbehusen, Hillary I.

AU - Schaffer, Joseph I.

AU - Wai, Clifford Y.

AU - Rahn, David D.

AU - Corton, Marlene M.

PY - 2012/12

Y1 - 2012/12

N2 - Introduction and hypothesis: Reports of sensory neuropathy attributed to uterosacral ligament suspension (USLS) have emerged. The objectives of this study were to assess the rate of sensory neuropathy symptoms following transvaginal USLS at a single institution during a 5-year period and to describe the evaluation, management, and outcomes in these patients. Methods: A retrospective review of records identified 278 women who underwent transvaginal USLS during the study period. Inpatient and outpatient records within the first 4 weeks postsurgery were reviewed. Women with new-onset buttock and/or lower-extremity pain, numbness, weakness or a combination of these symptoms were identified. Demographic data, intraoperative data, and management modalities and outcomes were collected. Results: Nineteen (6.8 %) women met criteria for inclusion. The most common symptom was buttock pain (73.7 % of cases). Pain radiation to the ipsilateral posterior thigh was present in 11 cases (57.9 %). The majority of women (73.7 %) reported pain symptoms on the right side. Conservative treatment modalities were initially implemented in all women. Four women (21 %) underwent suture removal a median of 1.75 months after USLS. Full symptom resolution was reported in 13 (68.4 %) women a median of 6 months after USLS. The remaining women experienced partial symptom resolution with ongoing conservative management. Conclusions: Sensory neuropathy is common in women who undergo transvaginal USLS. As quality of life may be significantly affected, any symptoms of buttock or lower-extremity pain in the immediate postoperative period warrant a thorough evaluation and close follow-up, with early suture removal consideration.

AB - Introduction and hypothesis: Reports of sensory neuropathy attributed to uterosacral ligament suspension (USLS) have emerged. The objectives of this study were to assess the rate of sensory neuropathy symptoms following transvaginal USLS at a single institution during a 5-year period and to describe the evaluation, management, and outcomes in these patients. Methods: A retrospective review of records identified 278 women who underwent transvaginal USLS during the study period. Inpatient and outpatient records within the first 4 weeks postsurgery were reviewed. Women with new-onset buttock and/or lower-extremity pain, numbness, weakness or a combination of these symptoms were identified. Demographic data, intraoperative data, and management modalities and outcomes were collected. Results: Nineteen (6.8 %) women met criteria for inclusion. The most common symptom was buttock pain (73.7 % of cases). Pain radiation to the ipsilateral posterior thigh was present in 11 cases (57.9 %). The majority of women (73.7 %) reported pain symptoms on the right side. Conservative treatment modalities were initially implemented in all women. Four women (21 %) underwent suture removal a median of 1.75 months after USLS. Full symptom resolution was reported in 13 (68.4 %) women a median of 6 months after USLS. The remaining women experienced partial symptom resolution with ongoing conservative management. Conclusions: Sensory neuropathy is common in women who undergo transvaginal USLS. As quality of life may be significantly affected, any symptoms of buttock or lower-extremity pain in the immediate postoperative period warrant a thorough evaluation and close follow-up, with early suture removal consideration.

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KW - Uterosacral ligament suspension

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U2 - 10.1007/s00192-012-1810-3

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