Comparison of short-term outcomes following pelvic reconstruction with Perigee and Apogee systems: Hysterectomy or not?

Introduction and hypothesis: This study aims to compare the surgical outcomes between hysterectomy and uterine preservation in pelvic reconstruction with Perigee® and Apogee® systems for severe pelvic organ prolapse. Methods: Ninety-one women who have undergone transvaginal pelvic reconstructive surgery with Perigee and Apogee systems for severe pelvic organ prolapse were divided into two groups: hysterectomy (n=39) and uterine preservation (n=52). The pre-operative and post-operative assessments include subjective urinary and prolapse symptoms, objective pelvic organ prolapse quantification (POP-Q) system, urodynamic examination, and complications. Results: The mean follow-up period was 8.9 months (range, 0.9-26.5). There were no anatomical differences between the two groups other than a longer perineal body in the hysterectomy group (3.9 vs. 3.6, p<0.05) and a longer total vaginal length in the uterine preservation group (8.2 vs. 7.8, p<0.05). Preservation of uterus has significantly reduced operative time, blood loss, and days of urine indwelling catheter (p<0.001). Conclusions: Hysterectomy and uterine preservation have comparable anatomical outcomes and post-operative complications in pelvic reconstruction with Perigee and Apogee systems at short-term follow-up.