A Study on Laparoscopic Sacral Colpopexy for Uterine Prolapse

Abstract

ObjectivesWe sought to describe the perioperative and postoperative adverse events associated with sacral colpopexy and evaluate the surgical outcome, complications, and benefits of laparoscopic sacral fixation for patients with pelvic prolapse.MethodsNinety-two women with uterine prolapse underwent sacral colpopexy between January 2011 and September 2016 at Chosun University Hospital. Patients' electronic medical records were investigated for demographic, intraoperative, and postoperative data. Strict definitions were used for all clinically relevant adverse events. Patients' outcomes were documented with 1 self-administered quality of life questionnaires: the Pelvic Floor Distress Inventory-20 focused on symptom distress. The primary analysis looking at perioperative and postoperative adverse events was descriptive and statistics were reported for all groups as n/N (%) with 95% confidence intervals for categorical variables and as mean ± standard deviation and mean (range) for all continuous variables.ResultsTheir mean age was 69 ± 8.1 years, mean follow-up duration was 12 months, and mean operating time was 61 minutes. There were seven conversions due to anesthetic or surgical difficulties. Follow-up was performed using a telephone questionnaire and physical examination at 12 months. There were three cases of sacral pain with strong analgesics, one of vaginal erosion, two of transient urinary retentions, one of spondylitis, and two of mesh infection. Of the patients, 98.9% were satisfied with the surgical results, while none complained of sexual dysfunction or problems performing her usual activities.ConclusionsLaparoscopic sacral colpopexy is a feasible and highly effective technique that offers good long-term results with complication rates similar to those of open surgery with the added benefit of being minimally invasive.

From Open to Minimally Invasive: The Sacrocolpopexy

“…Cho et al performed a large case review to compare LSC to the traditional open procedure. There were no significant intraoperative complications other than a 1.08% risk of blood transfusion, and a low rate of postoperative complications (8% constipation, 4% lower abdominal discomfort, 5% urge incontinence, 4% vaginal spotting, and less than 3% for all other complications) [43]. Meticulous mesh placement and improved visualization resulted in good long-term outcomes (0% relapse rate at 1 year) [20].…”

“…Descriptions of mesh problems associated with placement by endoscopic procedures are even more rare. Available data pertains to the risks that are mostly those specific to laparoscopy, use of general anesthesia, pneumoperitoneum and prolonged Trendelenburg positioning [42,43]. Complications of vaginal POP repairs with mesh are widely reported, however, what is attributable to poor technique versus mesh itself is debatable.…”

“…Meticulous mesh placement and improved visualization resulted in good long-term outcomes (0% relapse rate at 1 year) [20]. 98.8% of women were satisfied with their surgical outcome, with no reports of sexual dysfunction [43]. Altogether, these results show that the minimally invasive approach has better outcomes comparable to the abdominal approach, and is also significantly safer and more efficient [46].…”

Efficacy of mesh bilaterally sacrospinous ligament suspension versus laparoscopic sacrocolpopexy in patients with uterine prolapse

“…Therefore, focus have been laid on postoperative pain in patients with uterine prolapse in clinical practice. Another study 22 showed that LSC could evidently relieve the postoperative pain of patients with uterine prolapse. Similarly, our results found that the degree of pain in the study group was lower than that in the control group 6 months after operation (P < 0.05), indicating MSSLS was capable of effectively relieving the pain degree of patients with uterine prolapse.…”