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Medium term anatomical and functional outcomes following modified laparoscopic sacrocolpopexy

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Abstract

Introduction and hypothesis

We evaluated the anatomical and functional outcomes following modified laparoscopic sacrocolpopexy (LSC) utilizing deep dissection of the vaginal walls and distal mesh fixation at the anterior and posterior compartments. We hypothesized that anatomical and functional outcomes improve after this modified LSC technique.

Methods

This was a retrospective study of all women (n = 240) who underwent LSC for pelvic organ prolapse (POP) from January to December 2017 in a tertiary center. POP-Q staging, validated questionnaires (International Consultation on Incontinence Questionnaire-Short Form [ICIQ-SF] and Pelvic Floor Distress Inventory Questionnaire-Short Form), and uroflowmetry were used to evaluate the anatomical and functional outcomes. Statistical analyses were performed using McNemar test and repeated measures analysis of variance with Fisher’s least significant difference post hoc (p < 0.05).

Results

The anatomical success rate is 96%, with a prolapse recurrence rate of 3.8% at 3-year follow-up. Bulge symptoms and anatomical compartments were significantly improved after LSC. Clinically, there were significant improvements after LSC in voiding dysfunction and bowel symptoms. Also, there was a significant increase in stress urinary incontinence and non-significant decrease in mixed urinary incontinence and urge urinary incontinence. ICIQ-SF and Colorectal-Anal Distress Inventory 8 scores were significantly lower after LSC, signifying improvement in incontinence and bowel symptoms.

Conclusion

Our modified LSC technique is safe and effective in restoring level 1 and level 2 supports, without adverse effects on urinary and bowel function. Bladder and bowel symptoms have also been found to keep improving over time.

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Abbreviations

CRADI-8:

Colorectal-Anal Distress Inventory 8

ICIQ-SF:

International Consultation on Incontinence Questionnaire-Short Form

LSC:

Laparoscopic sacrocolpopexy

MUI:

Mixed urinary incontinence

PFDI-20:

Pelvic Floor Distress Inventory Questionnaire-Short Form

POP:

Pelvic organ prolapse

SUI:

Stress urinary incontinence

UUI:

Urge urinary incontinence

VD:

Voiding dysfunction

VVP:

Vaginal vault prolapse

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Authors and Affiliations

  1. Urogynecology Center, Kameda Medical Center, 929 Higashicho, Kamogawa, Chiba, 296-0041, Japan

    Auran Rosanne B. Cortes, Tokumasa Hayashi, Masayoshi Nomura, Yugo Sawada, Shino Tokiwa & Mika Nagae

  2. Department of Obstetrics and Gynecology, Dr. Paulino J. Garcia Memorial Research and Medical Center, Mabini Street Extension, Cabanatuan City, Nueva Ecija, 3100, Philippines

    Auran Rosanne B. Cortes

Authors
  1. Auran Rosanne B. Cortes
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  2. Tokumasa Hayashi
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  3. Masayoshi Nomura
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  4. Yugo Sawada
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  5. Shino Tokiwa
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Contributions

Cortes ARB: Project development, Data collection/analysis, Manuscript writing

Hayashi T: Data analysis, Manuscript writing

Nomura M: Project development, Data collection

Sawada Y, Tokiwa S, Nagae M: Data collection

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Correspondence to Auran Rosanne B. Cortes.

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Cortes, A.R.B., Hayashi, T., Nomura, M. et al. Medium term anatomical and functional outcomes following modified laparoscopic sacrocolpopexy. Int Urogynecol J 33, 3111–3121 (2022). https://doi.org/10.1007/s00192-022-05076-x

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