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

Rountis, A; Zacharakis, Dimitrios; Athanasiou, Stavros; Kathopoulis, Nikolaos; Grigoriadis, Themos

doi:10.7759/cureus.18281

Cited by 4 publications

(4 citation statements)

References 37 publications

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“…Treatment options for uterine prolapse vary from conservative management to a laparoscopic surgical approach. [ 5 ] During pregnancy, most patients are managed conservatively by bed rest in the Trendelenburg position and application of a suspensory pessary. [ 6 ] However, the management approach should be individualized, depending on the severity of the prolapse and the gestational age.…”

Section: Introductionmentioning

confidence: 99%

Uterine prolapse in a term pregnancy: A case report

Ba'Abbad,

Turki,

Aldossary

et al. 2024

Case Reports in Women's Health

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Section: Introductionmentioning

confidence: 99%

Uterine prolapse in a term pregnancy: A case report

Ba'Abbad,

Turki,

Aldossary

et al. 2024

Case Reports in Women's Health

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“…Laparoscopic approach to uterosacral ligament suspension (L-USLS) is now frequently adopted to improve visualization and decrease the rate of injury to contiguous structures such as the ureters, vessels, rectum, and sacral nerves. It is suitable for the treatment of younger women with uterine descent that, eventually, allows the preservation of the uterus ( 7 , 8 ). The aim of this study is to analyze perioperative outcomes, in terms of complications and risk of recurrence and reoperation, of laparoscopic USLS procedure.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic uterosacral ligament suspension: a systematic review and meta-analysis of safety and durability

Ronsini¹,

Pasanisi²,

Cianci³

et al. 2023

Front. Surg.

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IntroductionPelvic organ prolapse (POP) is a widespread condition affecting from 40% to 60% of women. Reconstructive vaginal surgeries are the most commonly performed procedures to treat POP. Among those, uterosacral ligament suspension (USLS), which is usually performed transvaginally, preserves pelvic statics and dynamics and appears to be an effective method. Laparoscopic USLS is a valid alternative to vaginal approach, and the aim of our review is to confirm its safety and feasibility and to compare clinical outcomes among the procedures.Materials and methodsFollowing the recommendations in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, we systematically searched the PubMed and Scopus databases in December 2022. We made no restriction on the publication year nor on the country. Data about POP-Q recurrence rate (RR), intraoperative and postoperative complications (graded according to Clavien–Dindo classification), readmission rate, and reoperation rate were collected and analyzed. We used comparative studies for meta-analysis.ResultsA total of nine studies fulfilled inclusion criteria: two articles were non-comparative retrospective observational studies, three more articles were comparative studies where laparoscopic USLS was confronted with other surgical techniques (only data of laparoscopic USLS were analyzed), and four were comparative retrospective cohort studies between laparoscopic and vaginal USLS procedures. The comparative studies were enrolled in meta-analysis. Patients were analyzed concerning perioperative risks and the risk of recurrence. The meta-analysis highlighted that there was no clear inferiority of one technique over the other.DiscussionLaparoscopic USLS is a technique with a low complication rate and low recurrence rate. Indeed, laparoscopic procedure allows better identification of anatomical landmarks and access to retroperitoneum. Moreover, efficacy over time and durability of Laparoscopic (LPS) USLS was also observed. However, these data should be weighed in light of the length of follow-up, which was in a very short range. Further, focused and prospective studies will be necessary to confirm this finding.

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“…Furthermore, there are other treatment approaches for POP including, laparotomy, laparoscopy, and robotassisted laparoscopy. A systematic review on the Role of Laparoscopic Surgery in the Treatment of Advanced Uterine Prolapse showed that minimally invasive surgery can be used efficiently as an alternative to open surgery in the treatment of severe uterine prolapse [24]. Likewise, a 2 years prospective double center study on Laparoscopic Lateral Suspension (LLS) with mesh for apical and anterior Pelvic Organ Prolapse showed that at 2 years 89% of patients were asymptomatic, the anatomic success rate was 94.2% for the anterior compartment, and 94.9% for the apical compartment.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and surgical outcomes of stage 3 and 4 pelvic organs prolapse in Jimma university medical center, south west Ethiopia

et al. 2022

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Background Pelvic organ prolapse (POP) affects about half of the women and affects their quality of life. The current study is, therefore, aimed at determining the prevalence and surgical outcomes of severe stage POP at Jimma University medical center from November 2016 to May 2018. Method A Hospital-based cross-sectional study was conducted on all patients with stage 3 and 4 POP, who were admitted, and had surgery. Data were collected from the patient’s chart, and logbooks, which were filled up from entry till her discharge. A Simplified POPQ(S-POPQ) was used to stage the prolapse at admission, at discharge, and three months follow-ups. Results Among 92 patients who were analyzed, POP accounts for 10.6% of all gynecologic admissions, and 43.8% of all gynecologic surgeries. The mean age of patients is 46 (± 12) years, and nearly 34% of the patients had stage 3 and 66% had stage 4 POP. Based on the type of prolapse, 93.5% of patients had stage 3 and more anterior vaginal wall prolapse (AVWP) and apical prolapse, while 57.6% had stage 3 or more posterior vaginal wall prolapse. Out of 72 patients who had anterior colporrhaphy, 58.7% had anterior colporrhaphy with colposuspension. Out of 83 patients who had apical suspension, 48.2%, 39.8%, and 12% had uterosacral, sacrospinous, and Richardson respectively. Ninety-seven patients had stage 0 or 1 POP at discharge while 90% of 20 patients who returned for follow-up at three months had stage 0 or 1 POP. Eight patients had surgery-related complications; bladder injury, urinary retention, Hemorrhage during SSLF, and rectal injury. Conclusion The prevalence of pelvic organ prolapse is high and the majority of patients presented with advanced-stage pelvic organ prolapse, with a long duration of symptoms and associated problems. The surgical techniques used have resulted in a high immediate success rate of 97% and 90% at discharge and three months follow up respectively. Therefore, awareness creation activities are important to facilitate an early presentation for treatment to improve the quality of life and the current surgical technique; native tissue vaginal repair (NTVR), being practiced in the setup has had better success.

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

Cited by 4 publications

References 37 publications

Uterine prolapse in a term pregnancy: A case report

Uterine prolapse in a term pregnancy: A case report

Laparoscopic uterosacral ligament suspension: a systematic review and meta-analysis of safety and durability

Prevalence and surgical outcomes of stage 3 and 4 pelvic organs prolapse in Jimma university medical center, south west Ethiopia

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