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Laparoscopic sacral hysteropexy versus laparoscopic sacrocolpopexy with hysterectomy for pelvic organ prolapse

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Abstract

Introduction and hypothesis

Treating pelvic organ prolapse (POP) with uterine conservation and sacral hysteropexy has uncertain subjective and objective outcomes. We sought to compare laparoscopic sacral hysteropexy with laparoscopic sacrocolpopexy/total laparoscopic hysterectomy (TLH with LSC).

Methods

Clinical data of 34 patients who underwent TLH with LSC and 65 patients who underwent laparoscopic sacral hysteropexy performed by the same group of surgeons between January 2008 and December 2013 were reviewed retrospectively. The primary outcome was subjective satisfaction rate based upon validated questionnaire (Patient Global Impression of Change [PGI-C]). Secondary outcomes were: anatomical cure, impact on quality of life based upon validated questionnaires (pelvic floor distress inventory-short form 20 [PFDI-20], Pelvic Floor Impact Questionnaire 7 [PFIQ-7], and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-12 [PISQ-12]), surgical complications, and cost.

Results

After a mean follow-up of 33 months, the subjective satisfaction rate was significantly higher in the TLH with LSC cohort (92.3 % vs 100 %; p < 0.001). The POP-Q scores in both groups were significantly improved postoperatively. However, the anatomical cure in the two groups (72.3 % vs 88.2 %; p = 0.07) did not differ significantly The postoperative PFIQ-7 and PFDI-20 scores were significantly better in the TLH with LSC cohort than in the laparoscopic sacral hysteropexy cohort (p = 0.043 and p = 0.035 respectively).

Conclusions

Relative to laparoscopic sacral hysteropexy, the TLH with LSC approach provides similar anatomical results, excellent patient satisfaction, and improved quality of life scores.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Southwest Hospital, Third Military Medical University, Chongqing, 400038, China

    Ke Pan, Lili Cao, Yanzhou Wang & Huicheng Xu

  2. Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA

    Nicholas A. Ryan

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  1. Ke Pan
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  2. Lili Cao
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  4. Yanzhou Wang
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  5. Huicheng Xu
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Correspondence to Huicheng Xu.

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Pan, K., Cao, L., Ryan, N.A. et al. Laparoscopic sacral hysteropexy versus laparoscopic sacrocolpopexy with hysterectomy for pelvic organ prolapse. Int Urogynecol J 27, 93–101 (2016). https://doi.org/10.1007/s00192-015-2775-9

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  • DOI: https://doi.org/10.1007/s00192-015-2775-9

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