{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:32:07Z","timestamp":1790209927178,"version":"4.1.0"},"reference-count":35,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,12,27]],"date-time":"2018-12-27T00:00:00Z","timestamp":1545868800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Mercy Public Hospitals Inc. (MPHI)"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The study aims to evaluate the long\u2010term results of the extraperitoneal uterosacral ligament suspension (bilateral) technique in women with apical prolapse following hysterectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Longitudinal clinical follow up conducted between June 2002 and December 2017.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Tertiary urogynaecology centre in Melbourne, Australia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population<\/jats:title>\n                    <jats:p>\n                      A total of 472 women with symptomatic vault prolapse who underwent bilateral extraperitoneal uterosacral ligament suspension (\n                      <jats:styled-content style=\"fixed-case\">EPUSLS<\/jats:styled-content>\n                      ). Of these patients, 61% (287\/472) had previously had a procedure for pelvic organ prolapse (\n                      <jats:styled-content style=\"fixed-case\">POP<\/jats:styled-content>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Follow up using structured, standardised questionnaires and examination by\n                      <jats:styled-content style=\"fixed-case\">POP<\/jats:styled-content>\n                      \u2010Q and Baden\u2013Walker system pre\u2010 and postoperatively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Functional and anatomical results and surgical complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Mean follow\u2010up duration was approximately 5\u00a0years. The objective success rate at vaginal cuff support was 89% (420\/472). Only 4% needed revision surgery for vault recurrence. There was improvement in bladder, bowel, and sexual symptoms after the procedure. Mesh exposure rate was 17% (of the 138 having mesh augmentation), with the majority of cases managed conservatively or with minor interventions. The ureteric injury rate was 1% and mainly occurred in patients operated early on in the series. No women had buttock pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      <jats:styled-content style=\"fixed-case\">EPUSLS<\/jats:styled-content>\n                      is an effective, suture\u2010based procedure for vault prolapse with few complications even on long\u2010term follow up. This technique avoids the need to open the peritoneum vaginally and has a low risk of ureteric injury and gluteal pain.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Tweetable abstract<\/jats:title>\n                    <jats:p>\n                      Bilateral extraperitoneal\n                      <jats:styled-content style=\"fixed-case\">USL<\/jats:styled-content>\n                      suspension of vault is effective with low morbidity and a high success rate.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.15560","type":"journal-article","created":{"date-parts":[[2018,11,21]],"date-time":"2018-11-21T02:56:54Z","timestamp":1542769014000},"page":"536-542","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Extraperitoneal uterosacral suspension technique for post hysterectomy apical prolapse in 472 women: results from a longitudinal clinical study"],"prefix":"10.1111","volume":"126","author":[{"given":"D","family":"Karmakar","sequence":"first","affiliation":[{"name":"Department of Urogynaecology Mercy Hospital for Women Heidelberg  Vic. 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