Surgical Outcomes of Laparoscopic Sacrocolpopexy and Sacrohysteropexy for Apical Prolapse Repair
Year: 2020
Type: article
Study design: Observational Study
Abstract: Objective: To evaluate outcomes of laparoscopic sacrocolpopexy (LSC) and sacrohysteropexy (LSH) regardingsuccess rates, recurrence rates, and perioperative complications. Materials and Methods: Retrospective cohort study of women undergoing LSC and LSH for symptomatic pelvic organ prolapse (POP) (≥ stage 2) was conducted at Kameda Medical Center, Japan between July 2013 and June 2015. All procedures were performed by one urogynecologist. Supracervical hysterectomy was performed in all women prior to LSC. Self-cut polypropylene mesh was used for mesh reinforcement. Information regarding patients’ demographics, preoperative assessment, perioperative complications, and surgical outcomes were analyzed. Anatomical success rate was defined as prolapse (points Aa, Ap, and C) located above hymen at 1-year follow-up. Results: LSC was performed in 43 patients while LSH was undertaken in 16. The mean age was 62.8 ± 9.1 years old. Patients undergoing LSC presented more advanced stage prolapse and POP-Q measurements than those in the hysteropexy group. The mean operative time spent for LSH was significantly shorter than the time spent for LSC. Bladder perforation was the only major complication encountered. At 1-year follow-up, significant improvement in POP-Q measurements was demonstrated in all compartments for both groups. The overall success rate was 89.8% (86% LSC and 100% LSH; p value 0.176). The anatomical success specifically for apical compartment was 96.6%. Conclusion: LSC and LSH are feasible and effective procedures for POP repair especially apical compartment. However, high competency in laparoscopy is required to ensure safety and success. Appropriate patient selection for both procedure is a practical point of concern. Long-term follow-up is necessary.
Source: Royal Thai Army Medical Journal
Institutions: Phramongkutklao Hospital, Kameda Medical Center
Language: English
Subfield: Urology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7218006967