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Eur Urol. 2009 Jun;55(6):1459-67. doi: 10.1016/j.eururo.2008.12.008. Epub 2008 Dec 17.

Medium-term anatomic and functional results of laparoscopic sacrocolpopexy beyond the learning curve.

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  • 1Pelvic Floor Unit, University Hospitals Leuven, Katholieke Universiteit Leuven, Leuven, Belgium.

Abstract

BACKGROUND:

Limited prospective data on the anatomic and functional outcome after laparoscopic sacrocolpopexy (LSC) are available in the literature.

OBJECTIVE:

To describe the medium-term anatomic and functional outcome of LSC.

DESIGN, SETTING, AND PARTICIPANTS:

Prospective consecutive series of 132 women with vaginal vault prolapse undergoing LSC between 2001 and 2006, which was after our learning curve. Patients with urodynamically proven stress incontinence (SI) underwent a concomitant tension-free vaginal tape (TVT) procedure.

INTERVENTION:

Patients underwent LSC with a polypropylene implant.

MEASUREMENTS:

Principal outcome measures were anatomic cure (stage 1 or lower) assessed by the Pelvic Organ Prolapse Quantification (POPQ) system and subjective cure and impact on quality of life measured by a standardised interview and, since its introduction in 2004, by a prolapse-specific quality-of-life questionnaire (P-QOL).

RESULTS AND LIMITATIONS:

At a mean follow-up of 12.5 mo, the anatomic cure rate for the apex was 98%. Anatomic failures elsewhere were mainly at the posterior compartment (18%). Subjective prolapse cure rate was 91.7%, and no patients required reoperation for recurrent prolapse. Symptoms of preoperative SI, urge incontinence, or constipation were cured in 43%, 46%, and 42% of patients, respectively. The rate of de novo SI was 7.3%. De novo constipation developed in 5% and de novo dyspareunia developed in 19%. Patients' quality of life improved significantly. Erosions occurred in 4.5%, all within 1 yr. A limitation of the study is that the quality-of-life assessment score became available halfway through the study, limiting the number of preoperative observations (n=36).

CONCLUSIONS:

We demonstrated that LSC results in good anatomic outcome and subjective cure of prolapse symptoms at medium term. The posterior compartment was most vulnerable for recurrence.

[PubMed - indexed for MEDLINE]
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