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Patient satisfaction after laparoscopic lateral suspension with mesh for pelvic organ prolapse: outcome report of a continuous series of 417 patients

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Abstract

Introduction and hypothesis

Sacropexy is considered the gold standard for the treatment of pelvic organ prolapse (POP) although dissection of the promontory may be challenging, particularly in obese women. Laparoscopic lateral suspension with mesh (LLS) could be an alternative.

Methods

LLS provides lateral attachment by fibrosis of a vesicovaginal mesh. Clinical evaluation was performed at 1 year using the simplified POP quantification system (POP-Q). Primary outcomes were objective and subjective cure at 1 year. After a mean of 7.2 years the rates of reoperation and complications were assessed as secondary outcomes. Patient satisfaction was evaluated by telephone interview using a ten-point-scale and the PGI-I scale. Factors predicting satisfaction were determined by logistic regression analysis.

Results

A total of 417 patients were treated between 2003 and 2011. At 1 year 78.4% of patients were asymptomatic and anatomic success rates were 91.6% for the anterior compartment, 93.6% for the apical compartment and 85.3% for the posterior compartment. The complication rate of Clavien-Dindo grade III or higher was 2.2%. The mesh exposure rate was 4.3% and the reoperation rate was 7.3%. Of the 417 patients, 214 participated in the telephone interview. Over 85% rated their situation as improved and satisfaction was associated with the absence of concomitant hysterectomy.

Conclusions

LLS is a safe technique with promising results in terms of a composite outcome, low complication rates and high long-term patient satisfaction. However, a randomized controlled trial is needed to establish the technique as an alternative to sacropexy in the treatment of POP in obese and high morbidity patients.

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Acknowledgements

We thank Marc Arcens for the creation of the illustrations.

Author information

Authors and Affiliations

  1. Faculty of Medicine, University of Geneva, Geneva, Switzerland

    Nikolaus Veit-Rubin, Jean-Bernard Dubuisson, Angèle Gayet-Ageron, Sören Lange, Isabelle Eperon & Jean Dubuisson

  2. Department of Obstetrics and Gynecology, Medical University Vienna, Vienna, Austria

    Nikolaus Veit-Rubin

  3. Gynaecology Centre, Clinique La Colline, Geneva, Switzerland

    Jean-Bernard Dubuisson

  4. CRC & Division of Clinical Epidemiology, Department of Health and Community Medicine, University Hospitals Geneva, Geneva, Switzerland

    Angèle Gayet-Ageron

  5. Department of Obstetrics and Gynecology, University Hospitals Geneva, Geneva, Switzerland

    Sören Lange, Isabelle Eperon & Jean Dubuisson

Authors
  1. Nikolaus Veit-Rubin
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  2. Jean-Bernard Dubuisson
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  3. Angèle Gayet-Ageron
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  4. Sören Lange
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  5. Isabelle Eperon
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  6. Jean Dubuisson
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Corresponding author

Correspondence to Nikolaus Veit-Rubin.

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Conflicts of interest

Jean-Bernard Dubuisson is a medical advisor for pfm medical ag, Köln, Germany.

All other authors declare that they have no conflicts of interest.

Funding

Pfm medical ag, Köln, Germany, contributed to the costs by funding the statistical analysis.

Additional information

Some results of the present study were presented as an e-poster and as a video presentation at the 40th Annual IUGA Meeting in Nice in June 2015, and have been published as an “IUJ video” in this journal (Int Urogynecol J 27(3):491–493, 2016).

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Veit-Rubin, N., Dubuisson, JB., Gayet-Ageron, A. et al. Patient satisfaction after laparoscopic lateral suspension with mesh for pelvic organ prolapse: outcome report of a continuous series of 417 patients. Int Urogynecol J 28, 1685–1693 (2017). https://doi.org/10.1007/s00192-017-3327-2

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  • DOI: https://doi.org/10.1007/s00192-017-3327-2

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