TY  - BOOK
AU  - Desale, Sameer
AU  - Iglesia, Cheryl B
AU  - Park, Amy J
AU  - Richter, Lee
TI  - Does Pelvic Organ Prolapse Quantification Examination D Point Predict Uterosacral Ligament Suspension Outcomes?
SN  - 2151-8378
PY  - 2016///
KW  - *Hysterectomy, Vaginal/mt [Methods]
KW  - *Ligaments/su [Surgery]
KW  - *Pelvic Organ Prolapse/su [Surgery]
KW  - *Preoperative Care/mt [Methods]
KW  - Aged
KW  - Female
KW  - Follow-Up Studies
KW  - Humans
KW  - Hysterectomy, Vaginal/ae [Adverse Effects]
KW  - Middle Aged
KW  - Pelvic Organ Prolapse/cl [Classification]
KW  - Pelvic Organ Prolapse/pp [Physiopathology]
KW  - Postoperative Period
KW  - Retrospective Studies
KW  - ROC Curve
KW  - Suburethral Slings
KW  - Surgical Mesh
KW  - Treatment Failure
KW  - MedStar Heart & Vascular Institute
KW  - MedStar Washington Hospital Center
KW  - Obstetrics and Gynecology/Female Pelvic Medicine and Reconstructive Surgery
KW  - Obstetrics and Gynecology/Urogynecology
KW  - Journal Article
N2  - CONCLUSIONS: The preoperative D point correlates with postoperative apical support, and a clinically meaningful relationship exists between the preoperative D point and anatomic apical success; METHODS: This retrospective cohort study included subjects undergoing transvaginal uterosacral ligament suspension from 2008 through 2013 who had at least 1 year follow-up. Demographic information, preoperative and postoperative Pelvic Organ Prolapse Quantification (POPQ) examination measurements, need for retreatment or repeat surgery, and assessment of pelvic floor symptoms were reviewed. Postoperative apical success was defined as C point descent no more than one third into the vaginal canal; OBJECTIVES: The best predictors for postoperative anatomic apical success after transvaginal uterosacral ligament suspension remain unknown. The aim of this study was to determine if there is a correlation between the preoperative D point and anatomic outcomes for apical prolapse after 1 year; RESULTS: One hundred twenty-five women met inclusion criteria and had follow-up at 1 year or more. Concomitant procedures included anterior/posterior repair and midurethral sling. Mean follow-up time was 22.8 months (range, 12-63 months). At last follow-up, 96% met criteria for apical success. A more negative preoperative D point was significantly related to improved postoperative apical support, with each 1-cm descent in preoperative D point resulting in a postoperative C point that was 0.21 cm lower (P = 0.0005). Based on the receiver operating characteristic curve, a "cutoff" D point value of -4.25 (sensitivity, 0.8; specificity, 0.65) was determined to be a predictor of postoperative apical success at 1 year or more
UR  - https://dx.doi.org/10.1097/SPV.0000000000000245
ER  -