TY  - BOOK
AU  - Gutman, Robert E
AU  - Iglesia, Cheryl B
AU  - Nosti, Patrick A
AU  - Park, Amy J
AU  - Sokol, Andrew I
AU  - Tefera, Eshetu
TI  - Defining Cervical Elongation: A Prospective Observational Study
SN  - 1701-2163
PY  - 2017///
KW  - *Cervix Uteri/pa [Pathology]
KW  - *Pelvic Organ Prolapse/pa [Pathology]
KW  - Aged
KW  - Body Mass Index
KW  - Female
KW  - Humans
KW  - Hysterectomy, Vaginal
KW  - Middle Aged
KW  - Operative Time
KW  - Parity
KW  - Pelvic Organ Prolapse/su [Surgery]
KW  - Prospective Studies
KW  - MedStar Health Research Institute
KW  - MedStar Washington Hospital Center
KW  - Obstetrics and Gynecology/Female Pelvic Medicine and Reconstructive Surgery
KW  - Journal Article
N2  - CONCLUSIONS: CE using our first definition was associated with a statistically significant increase in operative time in women undergoing hysterectomy at the time of prolapse repair; METHODS: Women undergoing vaginal hysterectomy and prolapse repair were enrolled. Office POP-Q measurements were collected. Estimates of cervical length were made based on points C minus D of the POP-Q and by manual exam using the surgeon's index and middle fingers. Cervical dimensions were measured from the pathology specimen at the end of the case. CE was defined as one standard deviation (SD) above the mean for each definition. Additional intraoperative data was collected to determine the surgeon perception of cervical anatomy; OBJECTIVES: Our primary aim was to define cervical elongation (CE) using the following methods: (1) measurement of pathology specimen, (2) physician perception, (3) intraoperative estimate of anterior cervical length, and (4) office Pelvic Organ Prolapse Quantification (POP-Q) points C and D. Our secondary aim was to determine whether these definitions correlate with perioperative outcomes; RESULTS: A total of 90 patients were enrolled during the study period. Our definitions for CE were as follows: (1) 5 cm (70 without and 20 with CE), (2) physician perception (67 without and 23 with CE), (3) 3.4 cm (79 without and 11 with CE), and (4) 8.3 cm (77 without and 13 with CE). After controlling for uterine weight and the presence of fibroids, the operative time was the only outcome measure that remained elevated for patients with CE using our first definition (42.4 +/- 20.1 without vs. 53.8 +/- 19.2 with CE, P = 0.03)
UR  - https://dx.doi.org/10.1016/j.jogc.2016.10.012
ER  -