Kasapidis, Madilynne C.
(2024)
Apical Prolapse: A Review of Treatments and Patient Outcomes.
Master Essay, University of Pittsburgh.
Abstract
This literature review evaluated the efficacy of surgical treatments for apical pelvic organ
prolapse (POP), focusing on recurrence rates and compartment-specific outcomes. Eligible studies
included women aged 18 years or older with Stage II-IV POP, with data published between 2000
and 2024 from the United States. Seven studies met the inclusion criteria, comprising three
randomized controlled trials (RCTs), three retrospective cohort studies, and one prospective cohort
study. The review assessed outcomes such as anatomical success, symptom relief, recurrence rates,
adverse events, and patient-reported measures. The findings highlighted significant differences in
recurrence rates among surgical techniques. Specifically, Sacrocolpopexy (SCP) consistently
demonstrated superior outcomes, particularly for Stage III prolapse, compared to uterosacral
ligament suspension (USLS) and sacrospinous ligament fixation (SSLF). For Stage II prolapse,
SCP and USLS showed comparable recurrence rates, suggesting SCP’s advantages are more
pronounced in advanced cases. Minimally invasive SCP (MISC) provided better anterior
compartment outcomes than vaginal USLS (vUSLS), while both techniques showed similar
improvements in overall prolapse severity. By contrast, SSLF and USLS had higher recurrence
and surgical failure rates over time, with anterior and posterior compartment failures being most
common. Despite SCP’s effectiveness, its use of mesh introduces risks of complications,
highlighting the need for continued evaluation of mesh-based repairs. The review also identified
disparities in long-term outcomes, emphasizing the importance of individualized treatment plans that consider prolapse stage, patient preferences, and recovery expectations. This review
underscores the complexity of surgical decision-making in apical POP management. SCP offers
durable outcomes for advanced prolapse, while less invasive techniques like USLS and vUSLS
remain viable options for moderate cases or patients unable to undergo mesh-based procedures.
These findings emphasize the need for long-term follow-up, robust comparisons across surgical
approaches, and greater focus on patient-centered outcomes. The public health relevance of this
review lies in its potential to improve the management of pelvic organ prolapse through evidence
based treatment decisions, ultimately enhancing the well-being of affected women and advancing
healthcare equity.
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Details
| Item Type: |
Other Thesis, Dissertation, or Long Paper
(Master Essay)
|
| Status: |
Unpublished |
| Creators/Authors: |
| Creators | Email | Pitt Username | ORCID  |
|---|
| Kasapidis, Madilynne C. | mck108@pitt.edu | MCK108 | |
|
| Contributors: |
| Contribution | Contributors Name | Email | Pitt Username | ORCID |
|---|
| Committee Chair | Glynn, Nancy W | epidnwg@pitt.edu | epidnwg | UNSPECIFIED | | Committee Member | Moalli, Pamela | moalpa@upmc.edu | UNSPECIFIED | UNSPECIFIED | | Committee Member | Baranski, Lindsey | baranskil@upmc.edu | UNSPECIFIED | UNSPECIFIED |
|
| ETD Committee: |
|
| Centers: |
Other Centers, Institutes, Offices, or Units > Magee-Women's Research Institute |
| Date: |
18 December 2024 |
| Date Type: |
Completion |
| Access Restriction: |
No restriction; Release the ETD for access worldwide immediately. |
| Number of Pages: |
44 |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
School of Public Health > Epidemiology |
| Degree: |
MPH - Master of Public Health |
| Thesis Type: |
Master Essay |
| Refereed: |
Yes |
| Date Deposited: |
18 Dec 2024 18:42 |
| Last Modified: |
18 Dec 2024 18:42 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/47225 |
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