Anatomical Outcome and Patient Satisfaction After Laparoscopic Uterosacral Ligament Hysteropexy for Anterior and Apical Prolapse

Yahya, Rani Haj; Chill, Henry H.; Herzberg, Shmuel; Asfour, A; Lesser, Steven; Shveiky, David

doi:10.1097/spv.0000000000000446

Cited by 17 publications

(11 citation statements)

References 12 publications

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“…Improvements on the PGI‐I scale were 90.6% and 76.5% for LLSUP and LLSHE, respectively ( P = .013). After LUSLS, 95%‐95.5% of women reported that their condition was “very much better” or “much better” . Anger et al compared LS (n = 38) and robotic sacropexy (RSC) (n = 40); both procedures were associated with low levels of postoperative pain, but patients who underwent RSC reported more pain and slower recovery.…”

Section: Resultsmentioning

confidence: 99%

“…Native tissue repairs have gained popularity following FDA notifications . Since April 16, 2019, there have been no FDA‐approved surgical mesh products for transvaginal repair marketed for use in the United States.…”

Section: Discussionmentioning

confidence: 99%

“…Native tissue repairs have gained popularity following FDA notifications. 7,37,38,43 Since April 16, 2019, there have been no FDA-approved surgical mesh products for transvaginal repair marketed for use in the United States. POP procedures using synthetic mesh require additional attention because of possible complications.…”

Section: Discussionmentioning

confidence: 99%

“…Pelvic organ prolapse (POP) is a worldwide health problem, the prevalence of which ranges from 10% in younger women to 50% in postmenopausal women. Apical defect, the least frequent of all POP types, has been reported in 5%‐15% of women . DeLancey established three levels of support for proper position of the pelvic organs: Level I: uterosacral ligaments (damage: uterine/vaginal vault prolapse, enterocoele); Level II: pubocervical and rectovaginal fascia (damage: cystocele, rectocele); Level III: perineal membrane and perineal body (damage: urethrocele, perineal body defect/excessive perineal descent) …”

Section: Introductionmentioning

confidence: 99%

“…Both uterosacral ligaments are isolated and anchored to the vaginal vault without mesh. A peritoneal release incision is made to avoid ureteric kinking; cystoscopy is used to confirm an unobstructed ureter . This technique involves connecting the pubocervical fascia to the pericervical ring and the continuity of supporting tissue is achieved after elevating the uterus by uterosacral ligament suspension.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of laparoscopic techniques for apical organ prolapse repair – a systematic review of the literature

Szymczak

Grzybowska

Wydra

2019

Neurourology and Urodynamics

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Aims Apical defect is a pelvic organ prolapse disorder, with 5%‐15% prevalence. The aim of the study was to investigate methods of laparoscopic repair of apical defect and compare them with other techniques (open, vaginal, and robotic). Methods A systematic search of the literature was conducted in MEDLINE/PubMed and ClinicalTrials.gov databases using the following key words: apical prolapse and treatment procedures. The search was limited by using the humans filters. Only articles published in English between 2010 and 2018 were considered. Two independent authors reviewed the publications for inclusion on the basis of the following criteria: (a) use of laparoscopic techniques, and (b) apical support loss as indication for surgery. Results A total of 1002 papers were initially identified; 24 studies fulfilled the inclusion criteria. Four main laparoscopic procedures were found. The reported anatomical success rate (POP‐Q < II stage) was 77%‐100%, with patient satisfaction for pectopexy, laparoscopic sacropexy (LS), lateral ligament suspension and laparoscopic uterosacral ligament suspension (LUSLS) of 96.4%‐97.6%, 71.0%‐100%, 66.7%‐87.8%, and 95%‐95.5%, respectively. Major complications included hemorrhage, bladder, ureter, and/or bowel injuries were rare. Prolapse recurrences after LUSLS and LS were reported in 13.2% and 10.4% of patients, respectively; with reoperation rate for LS 2.2%‐12.8%. Conclusions Most studies reported anatomical and subjective outcomes, with follow‐up ranging from 1 month to >7 years. Success rates for laparoscopic and abdominal corrections of apical defect were similar; laparoscopy was superior in terms of perioperative blood loss, length of hospital stay, and recovery.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%