Alas A, et al. – The purpose of this study is to determine whether vaginal hysterectomy with McCall culdoplasty as effective as in lesser degrees of prolapse. Total vaginal hysterectomy (TVH) with McCall culdoplasty is equally successful for the treatment of advanced uterovaginal prolapse as for the treatment of less severe pelvic organ prolapse (POP). Surgeons ought to consider this traditional surgery for their patients even if they have a high–stage uterovaginal prolapse.

Methods

• For this study, they designed a retrospective review.
• Women undergoing TVH with McCall culdoplasty from 2005 to 2014 were enrolled in this study.
• Advanced POP was characterized as exteriorized uterovaginal prolapse with Pelvic Organ Prolapse Quantification (POP–Q) point C, Ba or Bp ≥ 50% of the total vaginal length.
• The primary aim was to compare the surgical success of TVH with McCall culdoplasty for the repair of advanced POP and less severe POP at ≥ 1 year.

Results

• A sum of 311 women were incorporated, 38 with advanced POP and 273 with less severe POP.
• Women with advanced POP were older (71.6 vs. 61.8 years, respectively; p < 0.0001), but there were no major differences in the length of follow–up (102.5 vs. 117 weeks, p = 0.2378), success rates (76.3% vs. 68.5%, p = 0.3553) or reoperation rates (2.6% vs. 4%, p > 0.9999) between women with advanced POP and less severe POP, respectively.
• There was a higher failure rate in the anterior compartment in those with advanced POP (18.4% vs. 6.2%, p = 0.0168), but not in the apical or posterior compartment.