Laparoscopic sacral colpopexy and a new approach to mesh fixation: a randomized clinical trial

Morciano, Andrea; Marzo, Giuseppe; Caliandro, Dario; Campagna, Giuseppe; Panico, Giovanni; Alcaino, Simona; Bisanti, Tatiana; Ercoli, Alfredo; Romualdi, Daniela; Scambia, Giovanni

doi:10.1007/s00404-018-4916-0

Cited by 11 publications

(24 citation statements)

References 18 publications

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“…Five out of the six included studies reported no intraoperative complications [17,19,[23][24][25]. In the Fayyad et al study, two inadvertent bladder injuries (2, 9%) occurred during VALUES, which were repaired successfully at the time of surgery [18].…”

Section: Complicationsmentioning

confidence: 93%

“…Postoperative fever was reported in Morciano et al RCT [23] after LSH plus LSC in 3/84 (3.6%) patients, whilst pelvic hematoma occurred in 2/70 (2.8%) patients in Fayyad et al study [18] after VALUES. Finally, in the Athanasiou et al study [17], one patient (3.7%) complained about the presence of a prolene suture visible at the vaginal vault two months after VALS, which was ultimately removed under local anesthesia.…”

Section: Complicationsmentioning

confidence: 94%

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…The qualitative synthesis of this review consisted of one randomized controlled trial (RCT) [23], four prospective studies [17][18][19]24], and one retrospective study [25] and included a total of 359 patients. Vaginally assisted laparoscopic sacrocolpopexy (VALS) was the most common procedure performed for the treatment of severe uterovaginal prolapse (two studies) [17,19] followed by laparoscopic sacrocolpopexy (LSH) combined with laparoscopic supracervical hysterectomy (one study) [23]. Uterine-preserving techniques included laparoscopic inguinal ligament suspension (LILS) with mesh (1 study) [25], combined trachelectomy with laparoscopic uterosacral ligament suspension (LULS) (1 study) [24], and vaginallyassisted laparoscopic uterine sacropexy (VALUES) (1 study) [18].…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…Additionally, two studies involved a total of 42 patients (11.7%) with concomitant urinary stress incontinence (USI) preoperatively [18][19], and one study reported eight patients (2.2%) with urge incontinence (UI) prior to surgery [18]. In four studies, data regarding preoperative symptoms were not available [17,[23][24][25]. Table 3 [18].…”

Section: Patient Demographics Pop Characteristics and Preoperative Symptomsmentioning

confidence: 99%

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The Role of Laparoscopic Surgery in the Treatment of Advanced Uterine Prolapse: A Systematic Review of the Literature

Rountis¹,

Zacharakis²,

Athanasiou³

et al. 2021

Cureus

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The aim of this review is to investigate and compare all laparoscopic techniques that can be used in the surgical repair of advanced uterine prolapse. A systematic search of the PubMed, Scopus, Cochrane CENTRAL, and Clinicaltrials.gov databases was performed for articles published up to December 2020, reporting data on the treatment of severe uterine prolapse using laparoscopic procedures. Only studies in the English language, with a patient sample of ≥20 and a follow-up time of ≥12 months were included. The final synthesis of this review consisted of six studies. The main laparoscopic procedures reported were vaginally assisted laparoscopic sacrocolpopexy, vaginally assisted laparoscopic uterine sacropexy, laparoscopic sacrocolpopexy with laparoscopic supracervical hysterectomy, laparoscopic inguinal ligament suspension with uterine preservation, and laparoscopic uterosacral ligament suspension combined with trachelectomy. All procedures involved mesh placement, except for laparoscopic uterosacral ligament suspension. All procedures reported anatomical cure rates > 90%. Vaginally assisted laparoscopic sacrocolpopexy had the largest amount of intraoperative blood loss whilst vaginally assisted laparoscopic uterine sacropexy was associated with bladder injuries intraoperatively. All vaginally assisted procedures reported cases of mesh extrusion postoperatively. Laparoscopic inguinal ligament suspension was the operation with the longest mean operative and hospitalization time. Conversions were not reported. The present study shows that minimally invasive surgery can be used efficiently as an alternative to open surgery in the treatment of severe uterine prolapse.

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Section: Complicationsmentioning

confidence: 93%

Section: Complicationsmentioning

confidence: 94%

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

Section: Patient Demographics Pop Characteristics and Preoperative Symptomsmentioning

confidence: 99%

See 3 more Smart Citations

The Role of Laparoscopic Surgery in the Treatment of Advanced Uterine Prolapse: A Systematic Review of the Literature

Rountis¹,

Zacharakis²,

Athanasiou³

et al. 2021

Cureus

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Surgery for women with apical vaginal prolapse

Maher

Yeung

Haya

et al. 2023

Cochrane Database of Systematic Reviews

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Laparoscopic posterior vaginal plication plus sacral colpopexy for severe posterior vaginal prolapse: A randomized clinical trial

Morciano¹,

Ercoli

Caliandro³

et al. 2022

Neurourology and Urodynamics

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Aim: A randomized clinical trial proposing a new laparoscopic prosthetic and fascial approach to severe posterior vaginal prolapse. The primary endpoint was to evaluate the objective and subjective outcomes of our laparoscopic posterior plication (LPP) combined to "two-mesh" sacral colpopexy (laparoscopic sacral colpopexy [LSC]) in severe posterior vaginal prolapse, with a 1-year follow-up. The secondary endpoint was to evaluate the safety of this surgical procedure.Methods: This is single-center prospective randomized double-blinded clinical trial. A total of 130 consecutive patients with anterior and/or apical pelvic organ prolapse (POP) (POP-Q stage ≥II) and severe posterior vaginal prolapse (posterior POP-Q stage ≥III) were prospectively assessed for inclusion into the study from November 2018 to January 2020. Patients underwent "two-meshes" LSC and were randomized in Group A (LSC plus LPP) and Group A (LSC alone). Of the 130 included subjects, 8 were excluded, not meeting inclusion criteria. Cure rate was evaluated objectively, using POP-Q study, and subjectively using PGI-I, POPDI-6, and FSDS questionnaires. Complications were assessed intra-, peri-, and postoperatively. Twelve-month follow-ups were analyzed for the study.Results: We found in LSC plus LPP Group a significant improvement of Ap and genital hiatus POP-Q points. Our subjective study showed, at 12 months, a statistical difference in PGI-I successful outcomes rate in favor of LPP. Also the Neurourol Urodyn.

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Laparoscopic sacral colpopexy and a new approach to mesh fixation: a randomized clinical trial

Cited by 11 publications

References 18 publications

The Role of Laparoscopic Surgery in the Treatment of Advanced Uterine Prolapse: A Systematic Review of the Literature

The Role of Laparoscopic Surgery in the Treatment of Advanced Uterine Prolapse: A Systematic Review of the Literature

Surgery for women with apical vaginal prolapse

Laparoscopic posterior vaginal plication plus sacral colpopexy for severe posterior vaginal prolapse: A randomized clinical trial

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