Apical Prolapse: Is There a Best Approach?

We present some of the latest literature to help guide surgeons in clinical decision-making with respect to approach and type of suspension procedure.Recent FindingsMore hysterectomies for prolapse are being done with special attention to the apex as this is now an endorsed quality measure by NQF. The OPTIMAL Trial showed no difference in outcomes for uterosacral ligament suspension and sacrospinous ligament fixation. Sacrocolpopexy with mesh remains the most durable repair available but represents a more invasive approach than vaginal procedures.SummaryVaginal approaches continue to play a role in apical suspension especially for patients with uterovaginal prolapse at the time of hysterectomy and offer good long-term subjective and objective outcomes. Abdominal sacrocolpopexy is considered by many the “gold standard” in addressing apical prolapse, but laparoscopic and robotically assisted approaches offer less morbidity with similar short-term outcomes.
Source: Current Bladder Dysfunction Reports - Category: Urology & Nephrology Source Type: research