European journal of obstetrics, gynecology, and reproductive biology · 2026
The short-term outcomes of obliterative versus reconstructive vaginal surgery for pelvic organ prolapse: a retrospective study of the British Society of Urogynaecology database.
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Rangasamy Aruna, Chua Ker Yang, Latthe Pallavi
Аннотация
INTRODUCTION: Pelvic organ prolapse (POP) significantly affects women's quality of life. Data comparing different vaginal surgeries for POP remains limited. This study aimed to compare the subjective and objective outcomes of obliterative versus reconstructive vaginal surgeries for POP and factors associated with subjective improvement.
METHODOLOGY: A retrospective cohort study using data from the British Society of Urogynaecology database was conducted on women who underwent POP surgery in the United Kingdom (2007-2023). They either underwent obliterative (colpocleisis) or reconstructive surgery (sacrospinous ligament fixation, iliococcygeal fixation, or sacrospinous hysteropexy). The primary outcome was subjective improvement, defined as Patient Global Impression of Improvement (PGI-I) score of 1 or 2. Secondary outcomes included recurrence, complications, factors associated with subjective improvement, and effect of concurrent hysterectomy.
RESULTS: Women in the obliterative group had higher odds of achieving subjective improvement (OR: 1.49, 95% CI: 1.21-1.83, p < 0.001) and reduced complications compared to the reconstructive group. Concurrent hysterectomy increased surgery duration and estimated blood loss without significant increase in subjective improvement. Factors associated with subjective improvement were increasing age (OR: 1.02, 95% CI: 1.01 - 1.03; p < 0.001), lower BMI (OR: 1.03, 95% CI: 1.01-1.05, p < 0.001), no previous prolapse surgery (OR: 1.31, 95% CI: 1.09-1.56, p = 0.004), presence of pre-operative major prolapse (OR: 1.22, 95% CI: 1.01-1.46, p = 0.037), and having an obliterative surgery (OR: 1.87, 95% CI: 1.27-2.78, p = 0.002).
CONCLUSION: Women who had obliterative surgeries had higher subjective improvement with less complications compared to reconstructive surgeries, supporting colpocleisis as a viable option. Concurrent hysterectomy demonstrated increased complications.
METHODOLOGY: A retrospective cohort study using data from the British Society of Urogynaecology database was conducted on women who underwent POP surgery in the United Kingdom (2007-2023). They either underwent obliterative (colpocleisis) or reconstructive surgery (sacrospinous ligament fixation, iliococcygeal fixation, or sacrospinous hysteropexy). The primary outcome was subjective improvement, defined as Patient Global Impression of Improvement (PGI-I) score of 1 or 2. Secondary outcomes included recurrence, complications, factors associated with subjective improvement, and effect of concurrent hysterectomy.
RESULTS: Women in the obliterative group had higher odds of achieving subjective improvement (OR: 1.49, 95% CI: 1.21-1.83, p < 0.001) and reduced complications compared to the reconstructive group. Concurrent hysterectomy increased surgery duration and estimated blood loss without significant increase in subjective improvement. Factors associated with subjective improvement were increasing age (OR: 1.02, 95% CI: 1.01 - 1.03; p < 0.001), lower BMI (OR: 1.03, 95% CI: 1.01-1.05, p < 0.001), no previous prolapse surgery (OR: 1.31, 95% CI: 1.09-1.56, p = 0.004), presence of pre-operative major prolapse (OR: 1.22, 95% CI: 1.01-1.46, p = 0.037), and having an obliterative surgery (OR: 1.87, 95% CI: 1.27-2.78, p = 0.002).
CONCLUSION: Women who had obliterative surgeries had higher subjective improvement with less complications compared to reconstructive surgeries, supporting colpocleisis as a viable option. Concurrent hysterectomy demonstrated increased complications.