Long‐term anatomical and functional results of laparoscopic promontofixation for pelvic organ prolapse

Abstract

colposuspension or tension-free vaginal tape (TVT). The recurrence rate of POP was evaluated by physical examination at followup visits and by the patients, using a postal, unvalidated self-applied questionnaire (SAQ). Patients' urinary, sexual and digestive functions, overall satisfaction about surgery and quality of life, were evaluated with SAQ. RESULTSAll 186 patients had LP, with concomitant Burch (25) or TVT (100) procedures. The median (interquartile range) follow-up was 60 (48-71) months. In all, 71% of the patients attended their follow-up visits and the success rate was 92.4%. Eight patients were re-operated because of recurrent POP. The SAQ response rate was 95%; 91.1% and 79.8% of responders were satisfied or very satisfied after their surgery, and with their quality of life, respectively; women were unsatisfied or very unsatisfied because of recurrence of POP (seven), urinary symptoms (five) or constipation (two). Patients complained of recurrent POP (10.8%), persistent or recurrent UI (27.3% of the women treated with Burch and 21.1% with TVT), and transient constipation (20%). Over half of the women (50.6%) were not sexually active and 5.4% developed dyspareunia. The long-term complication rate was 6%; there were five vaginal mesh erosions. CONCLUSIONPOP treated with LP offers excellent longterm results with low recurrence and morbidity rates, and a good quality of life.

Laparoscopic promontofixation for pelvic organ prolapse: A 10‐year single center experience in a series of 501 patients

“…Sabbagh et al . performed a retrospective study of the 186 consecutive women who underwent LP for POP 12 . The median follow‐up was 60 months.…”

Laparoscopic sacral colpopexy: how to place the posterior mesh into rectovaginal space?

“…The simple size and the median follow‐up analyzed in this study could be considered the strengths of our paper, considering the existing literature …”

Prévenir les complications de la chirurgie prothétique du prolapsus : recommandations pour la pratique clinique – Revue de la littérature

“…Le Tableau 2 montre les taux de réintervention (taux global et taux de réintervention spécifique à des complications prothétiques) pour la promontofixation coelioscopique [11,[25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44].…”

“…Des érosions tardives viscérales (vésicale et digestive) ont été rapportées en promontofixation [32,47,48] et en chirurgie vaginale (éro-sion urétérale et digestive) [49,50]. La prévalence globale de ces érosions viscérales tardives est comprise entre 0,5 et 1 % pour la promontofixation coelioscopique [27] (NP4). Misrai et al rapportent deux expositions vésicales après promontofixation coelioscopique, l'une à 62 mois de suivi et l'autre à 40 mois [32].…”