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Association of Matrix Metalloproteinase-10 Polymorphisms With the Susceptibility to Pelvic Organ Prolapse
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Abstracts / Journal of Minimally Invasive Gynecology 22 (2015) S1–S253
improvement in UDI-6. More patients in the Burch group met the minimal important difference of the UDI6 with RR= 1.29. The IIQ-7 differences were not significant. The Burch group had significantly less pain (p=0.01). Conclusion: A Burch urethropexy at the time of sling removal results in a significant improvement in SUI symptomatology compared to sling removal only. Although this study has limitations, it suggests that a combined Burch for SUI and sling mesh complaints is a safe, effective option. 169 Posterior Vaginal Supracervical Hysterectomy: No Morcelment Juergens S, Bazargan M, Buchweitz O, Hackethal A, Specht W. Gynecology, Tagesklinik Altonaer Strasse, Hamburg, Germany Study Objective: There is some evidence that cervix sparing methods in hysterectomy have advantages in prophylaxis and therapy of POP. The objective of this retrospective study was to evaluate the step by step feasibility, safety, and efficacy of a new vaginal technique for supracervical hysterectomy using a posterior vaginal access to avoid laparoscopic or laparotomic incisions and morcelment. Design: Retrospective Study. Setting: Patients with pelvic organ prolaps(POP)underwent supracervical hysterectomy by a novel vaginal technique without morcelment. Patients: From January 2013 through January 2015, symptomatic pelvic organ prolapse in 43 patients was evaluated. Surgically treatment was performed between 2009 and 2015. Preoperative assessment included pelvic examination, the pelvic organ prolapse quantification scoring system (POP-Q), and complex urodynamic testing. Postoperative assessment included pelvic examination, the pelvic organ prolapse quantification scoring system (POP-Q) and patient survey after a period of minimun 3 months. Intervention: The surgical procedure of supracervical hysterectomy consisted of a vaginal posterior access through the fornix vaginae. Measurements and Main Results: The mean preoperative POP-Stage was 1.8, postoperatively 0.2. The mean preoperative hemoglobin level was 13.6 g/dl, postoperatively 11.1 g/dl. The mean blood loss during surgical treatment was 226.8 ml. The mean duration of surgical treatment was 114 minutes. The average duration of inpatient stay was 4.6 days. Conclusion: Potential advantages of this new procedure include accelleration of operation time, minimizing risks by avoiding abdominal approaches, avoiding morcelment. Longer follow-up is needed to determine the durability and potential long-term sequelae of the procedure. 170 Association of Matrix Metalloproteinase-10 Polymorphisms With the Susceptibility to Pelvic Organ Prolapse Wang H, Zhang ZQ, Wang SZ. Department of Obstetrics and Gynecology, Beijing Chaoyang Hospital, Affiliated Hospital Of Capital Medical University, Beijing, China Study Objective: To explore the correlation between the genetic mutations of matrix metalloproteinase-10 (MMP-10) and the susceptibility to pelvic organ prolapse (POP). Design: From September 2009 to December 2012, total MMP-10 concentration in serum was measured by Enzyme-linked immunosorbent assay (ELISA). The Genotyping of MMP-10 was determined by quantitative real-time PCR. All data were analyzed with the SPSS 18.0 statistical software. Setting: 263 subjects were recruited from Department of obstetrics and gynecology, Beijing Chaoyang Hospital. Patients: Beijing Chaoyang Hospital, affiliated Capital Medical University,Including 91 patients with POP (case group) and 172 non-POP patients (control group). Intervention: Total MMP-10 concentration in serum was measured by Enzyme-linked immunosorbent assay (ELISA). The Genotyping of
MMP-10 was determined by quantitative real-time PCR. All data were analyzed with the SPSS 18.0 statistical software. Measurements and Main Results: We found that the number of pregnancies (2.75 1.65 vs. 2.28 1.58), the proportion of menopause (50.55% vs. 37.79%), the proportion of history of total hysterectomy (14.29% vs. 4.07%), and the proportion of family history of POP (16.48% vs. 0.58%) in the POP group were significantly higher than those in the control group (P = 0.017, P = 0.046, P = 0.0029 and P \ 0.001, respectively). The serum MMP-10 levels in the POP group were obviously higher than those in the control group (P \ 0.05). In addition, there was a statistical significance of the distribution frequency of all genotypes in the MMP-10 gene (rs17435959G/ C) between the two groups (P \ 0.05). However, the distribution frequency of all genotypes in the MMP-10 gene (rs17293607C/T) between the two groups showed no significant differences (P \ 0.05). Conclusion: We supported the view that the polymorphism of rs17435959 of the MMP-10 gene may be associated with the increased risk of POP. WEDNESDAY, NOVEMBER 18, 2015 171
Open Communications 12 - Robotics (11:00 AM - 12:00 PM)
Preoperative Uterine Volume: Does It Predict Symptomatic Fibroid Recurrence After Robotic Myomectomy: A Retrospective Cohort Study Sangha R. Department of Obstetrics and Gynecology, Henry Ford Hospital, Detroit, Michigan Study Objective: To assess if pre-operative uterine volume is predictive of symptomatic fibroid recurrence after robotic myomectomy. Design: Retrospective cohort study. Setting: Henry Ford Hospitals (Detroit and West Bloomfield, MI). Patients: All women who underwent a robotic myomectomy prior to May 2009. Intervention: Robotic myomectomy. Measurements and Main Results: The electronic medical records of all women who were at least 2 year post- robotic myomectomy were reviewed for details about the surgery (preoperative uterine volume calculated by MRI, preoperative diameter of largest leiomyoma, weight of fibroids removed and cavity entry). The date of last contact with the woman was recorded. Date of specific mention of fibroids in the medical the record after the index myomectomy also recorded as were any additional fibroid-related procedures: myomectomy, uterine artery embolization (UAE) or hysterectomy . Survival analysis techniques were employed to account for variable follow-up and loss to follow-up (censored) for the outcomes of time to recurrence (first mention of fibroid or additional procedure) and time to retreatment. Of the 118 women, 17 (14%) had symptomatic clinical recurrence. There was no difference in preoperative uterine volume ( p=0.41) preoperative diameter of the largest fibroid ( p=.67), weight of the fibroids removed (p=0.65) and cavity entry ( p 0.54). Conclusion: These data do not provide evidence of differences in symptomatic recurrence after robotic myomectomy, based on uterine volume, weight of fibroids removed and other fibroid characteristics ( preoperative diameter of largest fibroid, cavity entry). 172 A Cost-Effective Approach in Gynecologic Robotic Surgery Bodur S, Dede M, Firatligil FB, Ulubay M, Yenen MC. Obstetrics and Gynecology, Gulhane Military Medical Academy, Ankara, Turkey Study Objective: To compare the cost-effectiveness of vaginal route and robotic intra-corporal suturation for vaginal vault closure (VVC) in patients undergoing robotic-assisted hysterectomy. Design: Retrospective study. Setting: Gulhane Military Medical Academy, Teaching Hospital, Department of Gynecology and Obstetrics, Ankara, Turkey. Patients: A sample of 30 women who underwent robotic surgery for benign gynecologic indications.
Abstracts / Journal of Minimally Invasive Gynecology 22 (2015) S1–S253
improvement in UDI-6. More patients in the Burch group met the minimal important difference of the UDI6 with RR= 1.29. The IIQ-7 differences were not significant. The Burch group had significantly less pain (p=0.01). Conclusion: A Burch urethropexy at the time of sling removal results in a significant improvement in SUI symptomatology compared to sling removal only. Although this study has limitations, it suggests that a combined Burch for SUI and sling mesh complaints is a safe, effective option. 169 Posterior Vaginal Supracervical Hysterectomy: No Morcelment Juergens S, Bazargan M, Buchweitz O, Hackethal A, Specht W. Gynecology, Tagesklinik Altonaer Strasse, Hamburg, Germany Study Objective: There is some evidence that cervix sparing methods in hysterectomy have advantages in prophylaxis and therapy of POP. The objective of this retrospective study was to evaluate the step by step feasibility, safety, and efficacy of a new vaginal technique for supracervical hysterectomy using a posterior vaginal access to avoid laparoscopic or laparotomic incisions and morcelment. Design: Retrospective Study. Setting: Patients with pelvic organ prolaps(POP)underwent supracervical hysterectomy by a novel vaginal technique without morcelment. Patients: From January 2013 through January 2015, symptomatic pelvic organ prolapse in 43 patients was evaluated. Surgically treatment was performed between 2009 and 2015. Preoperative assessment included pelvic examination, the pelvic organ prolapse quantification scoring system (POP-Q), and complex urodynamic testing. Postoperative assessment included pelvic examination, the pelvic organ prolapse quantification scoring system (POP-Q) and patient survey after a period of minimun 3 months. Intervention: The surgical procedure of supracervical hysterectomy consisted of a vaginal posterior access through the fornix vaginae. Measurements and Main Results: The mean preoperative POP-Stage was 1.8, postoperatively 0.2. The mean preoperative hemoglobin level was 13.6 g/dl, postoperatively 11.1 g/dl. The mean blood loss during surgical treatment was 226.8 ml. The mean duration of surgical treatment was 114 minutes. The average duration of inpatient stay was 4.6 days. Conclusion: Potential advantages of this new procedure include accelleration of operation time, minimizing risks by avoiding abdominal approaches, avoiding morcelment. Longer follow-up is needed to determine the durability and potential long-term sequelae of the procedure. 170 Association of Matrix Metalloproteinase-10 Polymorphisms With the Susceptibility to Pelvic Organ Prolapse Wang H, Zhang ZQ, Wang SZ. Department of Obstetrics and Gynecology, Beijing Chaoyang Hospital, Affiliated Hospital Of Capital Medical University, Beijing, China Study Objective: To explore the correlation between the genetic mutations of matrix metalloproteinase-10 (MMP-10) and the susceptibility to pelvic organ prolapse (POP). Design: From September 2009 to December 2012, total MMP-10 concentration in serum was measured by Enzyme-linked immunosorbent assay (ELISA). The Genotyping of MMP-10 was determined by quantitative real-time PCR. All data were analyzed with the SPSS 18.0 statistical software. Setting: 263 subjects were recruited from Department of obstetrics and gynecology, Beijing Chaoyang Hospital. Patients: Beijing Chaoyang Hospital, affiliated Capital Medical University,Including 91 patients with POP (case group) and 172 non-POP patients (control group). Intervention: Total MMP-10 concentration in serum was measured by Enzyme-linked immunosorbent assay (ELISA). The Genotyping of
MMP-10 was determined by quantitative real-time PCR. All data were analyzed with the SPSS 18.0 statistical software. Measurements and Main Results: We found that the number of pregnancies (2.75 1.65 vs. 2.28 1.58), the proportion of menopause (50.55% vs. 37.79%), the proportion of history of total hysterectomy (14.29% vs. 4.07%), and the proportion of family history of POP (16.48% vs. 0.58%) in the POP group were significantly higher than those in the control group (P = 0.017, P = 0.046, P = 0.0029 and P \ 0.001, respectively). The serum MMP-10 levels in the POP group were obviously higher than those in the control group (P \ 0.05). In addition, there was a statistical significance of the distribution frequency of all genotypes in the MMP-10 gene (rs17435959G/ C) between the two groups (P \ 0.05). However, the distribution frequency of all genotypes in the MMP-10 gene (rs17293607C/T) between the two groups showed no significant differences (P \ 0.05). Conclusion: We supported the view that the polymorphism of rs17435959 of the MMP-10 gene may be associated with the increased risk of POP. WEDNESDAY, NOVEMBER 18, 2015 171
Open Communications 12 - Robotics (11:00 AM - 12:00 PM)
Preoperative Uterine Volume: Does It Predict Symptomatic Fibroid Recurrence After Robotic Myomectomy: A Retrospective Cohort Study Sangha R. Department of Obstetrics and Gynecology, Henry Ford Hospital, Detroit, Michigan Study Objective: To assess if pre-operative uterine volume is predictive of symptomatic fibroid recurrence after robotic myomectomy. Design: Retrospective cohort study. Setting: Henry Ford Hospitals (Detroit and West Bloomfield, MI). Patients: All women who underwent a robotic myomectomy prior to May 2009. Intervention: Robotic myomectomy. Measurements and Main Results: The electronic medical records of all women who were at least 2 year post- robotic myomectomy were reviewed for details about the surgery (preoperative uterine volume calculated by MRI, preoperative diameter of largest leiomyoma, weight of fibroids removed and cavity entry). The date of last contact with the woman was recorded. Date of specific mention of fibroids in the medical the record after the index myomectomy also recorded as were any additional fibroid-related procedures: myomectomy, uterine artery embolization (UAE) or hysterectomy . Survival analysis techniques were employed to account for variable follow-up and loss to follow-up (censored) for the outcomes of time to recurrence (first mention of fibroid or additional procedure) and time to retreatment. Of the 118 women, 17 (14%) had symptomatic clinical recurrence. There was no difference in preoperative uterine volume ( p=0.41) preoperative diameter of the largest fibroid ( p=.67), weight of the fibroids removed (p=0.65) and cavity entry ( p 0.54). Conclusion: These data do not provide evidence of differences in symptomatic recurrence after robotic myomectomy, based on uterine volume, weight of fibroids removed and other fibroid characteristics ( preoperative diameter of largest fibroid, cavity entry). 172 A Cost-Effective Approach in Gynecologic Robotic Surgery Bodur S, Dede M, Firatligil FB, Ulubay M, Yenen MC. Obstetrics and Gynecology, Gulhane Military Medical Academy, Ankara, Turkey Study Objective: To compare the cost-effectiveness of vaginal route and robotic intra-corporal suturation for vaginal vault closure (VVC) in patients undergoing robotic-assisted hysterectomy. Design: Retrospective study. Setting: Gulhane Military Medical Academy, Teaching Hospital, Department of Gynecology and Obstetrics, Ankara, Turkey. Patients: A sample of 30 women who underwent robotic surgery for benign gynecologic indications.