Laparoscopic sacrocolpopexy for uterine and post-hysterectomy prolapse: anatomical results, quality of life and perioperative outcome—a prospective study with 101 cases

Abstract

Our prospective study evaluates laparoscopic sacrocolpopexy for vaginal vault prolapse focusing on perioperative data, objective anatomical results using the pelvic organ prolapse quantification (POP-Q) system and postoperative quality of life using the Kings Health questionnaire. One hundred one patients completed the study. Fifty five had laparoscopic supracervical hysterectomy and sacrocolpopexy for uterine prolapse and 46 had laparoscopic sacrocolpopexy for post-hysterectomy prolapse. Median follow-up was 12 months. The subjective cure rate was 93% the objective cure rate (no prolapse in any compartment) according to the International Continence Society classification of prolapse was 98%. The main site of objective recurrence (6%) was the anterior compartment. No apical recurrences and no vaginal mesh erosion occurred. Postoperatively overall quality of life and sexual quality showed significant improvement with less than 1% de-novo dyspareunia. The procedure is recommended for experienced laparoscopic surgeons because of severe intraoperative complications like bladder or rectal injuries.

Laparoscopic sacrocolpopexy: impact of the learning curve. Historic retrospective comparative study between two series of 93 and 169 patients

“…This may be compared to the rates reported in the literature between 2.2% and 17.4% [18,[20][21][22][23][24][25]. Bladder wounding is the most frequent complication: 0.8-3% in our study vs. 1-7% in literature [8,9,[18][19][20][21][26][27][28][29][30][31]. Diagnosis was always made during intervention with immediate suture and simple aftereffects.…”

Safety and perioperative morbidity of laparoscopic sacropexy: a systematic analysis and a comparison with laparoscopic hysterectomy

“…Other complications which were described in literature, namely bowel injury in 0-3% and injury of main blood vessels in 0-1%, were not observed in our study [2,8,[25][26][27].…”

Anorectal symptoms before and after laparoscopic sacrocolpoperineopexy for pelvic organ prolapse

“…In a prospective study of laparoscopic sacrocolpopexy, North et al also reported improvement in anorectal symptoms, although the sample size was small [20]. In another study of 101 cases of laparoscopic sacrocolpopexy, Sarlos et al observed that nearly all cases of constipation, which constituted the main postoperative anorectal complaint occurring in 18.8% of the women, resolved after 6 months of medical treatment [21]. However, none of these aforementioned studies addressed anorectal symptoms specifically as their main outcome criteria for POP repair.…”