Skip to main content

Advertisement

SpringerLink
Log in

Laparoscopic sacral colpopexy with polyester fiber suture: Ozerkan modification

  • Original Article
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

Abstract

Introduction and hypothesis

Mesh-related problems are significant complications of laparoscopic sacral colpopexy. The conventional technique precludes performing laparoscopic sacral colpopexy without using a mesh. We describe the Ozerkan modification for laparoscopic sacral colpopexy using a polyester fiber suture instead of a standard mesh and report 1-year objective and subjective outcomes.

Methods

Women diagnosed with stage ≥ 2 vaginal vault prolapse were prospectively recruited for the Ozerkan modification between 2015 and 2017. The primary outcome was the anatomic success of the repair, defined by objective parameters using the pelvic organ prolapse quantification system (stage 0 or 1). Secondary outcomes were subjective outcomes assessed with the quality of life scores.

Results

Twenty-two women underwent the Ozerkan modified laparoscopic sacrocolpopexy. Mean operation time was 85.6 min. Mean estimated blood loss was 71 ml. One patient was lost during the clinical follow-up in the outpatient clinic up to 1 year. Nineteen of 21 patients had stage 0 or 1 prolapse at the end of 1 year. Two patients were not satisfied with their pelvic floor after 1 year. Both the objective and subjective cure rates were 90.4%. There were no bladder or bowel complications during the peri- or postoperative period.

Conclusions

The new modification of laparoscopic sacral colpopexy seems a feasible and safe option to avoid mesh complications in the treatment of vaginal vault prolapse.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Jones KA, Shepherd JP, Oliphant SS, Wang L, Bunker CH, Lowder JL. Trends in inpatient prolapse procedures in the United States, 1979-2006. Am J Obstet Gynecol. 2010;202(5):501.e1–7.

    Article  Google Scholar 

  2. Lane FE. Repair of post-hysterectomy vaginal vault prolapse. Obstet Gynecol. 1962;20:72–7.

    Article  CAS  Google Scholar 

  3. Maher C, Feiner B, Baessler K, Schmid C. Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev 2013; CD004014.

  4. https://www.federalregister.gov/documents/2016/01/05/2015-33165/obstetrical-and-gynecological-devices-reclassification-of-surgical-mesh-for-transvaginal-pelvic (Accessed on 05.12.2018).

  5. FDA decision on urogynecologic surgical mesh implants. 16.04.2019. https://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/UroGynSurgicalMesh/default.htm (Accessed on 23.04.2019).

  6. https://www.bbc.co.uk/news/health-44763673 (Accessed on 03.12.2018).

  7. Bump RC, Mattiasson A, Bø K, Brubaker LP, DeLancey JO, Klarskov P, et al. The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol. 1996 Jul;175(1):10–7.

    Article  CAS  Google Scholar 

  8. Barber MD, Walters MD, Bump RC. Short form of two condition specific quality-of-life questionnaires for women with pelvic floor disorders (PFDI-20 and PFIQ-7). Am J Obstet Gynecol. 2005;193:103–13.

    Article  CAS  Google Scholar 

  9. Yalcin I, Bump RC. Validation of two global impression questionnaires for incontinence. Am J Obstet Gynecol. 2003.

  10. 189:98. http://mijid.org/”.

  11. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205–13.

    Article  Google Scholar 

  12. Nygaard IE, McCreery R, Brubaker L, Connolly A, Cundiff G, Weber AM, et al. Abdominal sacrocolpopexy: a comprehensive review. Obstet Gynecol. 2004;104(4):805–23.

    Article  Google Scholar 

  13. Hilger WS, Poulson M, Norton PA. Long-term results of abdominal sacrocolpopexy. Am J Obstet Gynecol. 2003;189:1606.

    Article  Google Scholar 

  14. Bradley CS, Nygaard IE, Brown MB, et al. Bowel symptoms in women 1 year after sacrocolpopexy. Am J Obstet Gynecol. 2007;197:642.e1.

    Article  Google Scholar 

  15. Burgio KL, Nygaard IE, Richter HE, et al. Bladder symptoms 1 year after abdominal sacrocolpopexy with and without Burch colposuspension in women without preoperative stress incontinence symptoms. Am J Obstet Gynecol. 2007;197:647.e1.

    Article  Google Scholar 

  16. Guiahi M, Kenton K, Brubaker L. Sacrocolpopexy without concomitant posterior repair improves posterior compartment defects. Int Urogynecol J Pelvic Floor Dysfunct. 2008;19:1267.

    Article  Google Scholar 

  17. Brubaker L, Nygaard I, Richter HE, et al. Two-year outcomes after sacrocolpopexy with and without burch to prevent stress urinary incontinence. Obstet Gynecol. 2008;112:49.

    Article  Google Scholar 

  18. Baessler K, Hewson AD, Tunn R, Schuessler B, Maher CF. Severe mesh complications following intravaginal slingplasty. 2005;106(4):713–6.

  19. Vieillefosse S, Thubert T, Dache A, Hermieu JF, Deffieux X. Satisfaction, quality of life and lumbar pain following laparoscopic sacrocolpopexy: suture vs. tackers. Eur J Obstet Gynecol Reprod Biol. 2015;187:51–6.

    Article  Google Scholar 

  20. Arsene E, Giraudet G, Lucot JP, Rubod C, Cosson M. Sacral colpopexy: long-term mesh complications requiring reoperation(s). Int Urogynecol J. 2015;26(3):353–8.

    Article  Google Scholar 

  21. Cundiff GW, Varner E, Visco AG, Zyczynski HM, Nager CW, Norton PA, et al. Risk factors for mesh/suture erosion following sacral colpopexy. Am J Obstet Gynecol. 2008;199(6):688.e1–5.

    Article  Google Scholar 

  22. Siddiqui NY, Grimes CL, Casiano ER, Abed HT, Jeppson PC, Olivera CK, et al. Sung VW; Society of Gynecologic Surgeons Systematic Review Group. Mesh sacrocolpopexy compared with native tissue vaginal repair: a systematic review and meta-analysis. Obstet Gynecol. 2015;125(1):44–55.

    Article  Google Scholar 

  23. Brubaker L. Sacrocolpopexy and the anterior compartment: support and function. Am J Obstet Gynecol. 1995;173:1690.

    Article  CAS  Google Scholar 

  24. Nygaard I, Brubaker L, Zyczynski HM, et al. Long-term outcomes following abdominal sacrocolpopexy for pelvic organ prolapse. JAMA. 2013;309:2016.

    Article  CAS  Google Scholar 

  25. Orhan A, Ozerkan K, Vuruskan H, Ocakoglu G, Kasapoglu I, Koşan B, et al. Long-term follow-up of laparoscopic sacrocolpopexy: comparison of two different techniques used in urology and gynecology. Int Urogynecol J. 2019;30(4):623–32.

    Article  Google Scholar 

  26. Paraiso MF, Jelovsek JE, Frick A, Chen CC, Barber MD. Laparoscopic compared with robotic sacrocolpopexy for vaginal prolapse: a randomized controlled trial. Obstet Gynecol. 2011;118(5):1005–13.

    Article  Google Scholar 

  27. Maher C, Baessler K. Surgical management of anterior vaginal wall prolapse: an evidence-based literature review. Int Urogynecol J Pelvic Floor Dysfunct. 2006;17(2):195–201.

    Article  Google Scholar 

  28. Krause HG, Goh JT, Sloane K, Higgs P, Carey MP. Laparoscopic sacral suture hysteropexy for uterine prolapse. Int Urogynecol J Pelvic Floor Dysfunct. 2006;17(4):378–81.

    Article  Google Scholar 

Download references

Acknowledgements

The authors thank our residents for their help in collecting the data.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Endoscopy and Minimally Invasive Gynecology Unit, Uludag University Hospital, Gorukle Campus, 16059, Bursa, Turkey

    Kemal Ozerkan, Adnan Orhan, Isil Kasapoglu & Gurkan Uncu

  2. Department of Obstetrics and Gynecology, Koc University School of Medicine, Davutpasa Caddesi No: 4, Topkapi, 34010, Istanbul, Turkey

    Baris Ata

Authors
  1. Kemal Ozerkan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Adnan Orhan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Isil Kasapoglu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Baris Ata
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Gurkan Uncu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Adnan Orhan.

Ethics declarations

Conflict of interest

The authors have no conflicts of interest relevant to this article.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

(MP4 11759 kb)

(MP4 32821 kb)

(MP4 21568 kb)

(MP4 34500 kb)

ESM 5

(MP4 41290 kb)

ESM 6

(MP4 32688 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ozerkan, K., Orhan, A., Kasapoglu, I. et al. Laparoscopic sacral colpopexy with polyester fiber suture: Ozerkan modification. Int Urogynecol J 31, 1601–1607 (2020). https://doi.org/10.1007/s00192-019-04042-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00192-019-04042-4

Keywords

Search

Navigation