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International Urogynecology Journal

, Volume 29, Issue 10, pp 1455–1461 | Cite as

Uterus-sparing vaginolaparoscopic sacrocolpopexy for apical pelvic organ prolapse

  • Atef DarwishEmail author
  • Mostafa Bahlol
  • AbdelGhafar Ahmad
  • Mohamed Fekry
Original Article

Abstract

Introduction and hypothesis

Our aim was to evaluate the safety, feasibility, and effectiveness of a vaginolaparoscopic sacrocolpopexy (VLS) technique for treating apical pelvic organ prolapse (POP).

Materials and methods

This was a prospective interventional case series (design classification: Canadian Task Force II3) performed in the endoscopic unit of a tertiary care referral facility and university hospital. We assessed 15 symptomatic parous women with stage ≥2 apical POP according to the POP Quantification (POP-Q) classification. Interventions comprised posterior colpotomy with mesh fixation to the uterosacral ligaments and the back of the uterus that was further fixed to the anterior longitudinal ligament of the sacrum using a tacker via laparoscopy.

Results

The main outcome was a significant postoperative improvement in prolapse and resultant improvement in quality of life (QoL) after VLS. Six patients required concomitant reconstructive procedures. Mean operative time for the vaginal phase was 8.54 ± 3.10 (7–12) min and 32.36 ± 8.2 (27–41) min. for the laparoscopic phase Mean duration of VLS ranged from 30 to 50 min. At the 6-months follow-up, the procedure was successful in 14 of 15 patients (93.34%); one woman (6.66%) presented with recurrence at a lower stage. Neither mesh complications nor sacral ostitis were encountered. There was significant improvement in vaginal symptoms, sexual well-being, QoL, and clinical staging after the procedure.

Conclusion

By eliminating all forms of intraperitoneal suturing, performing a posterior colpotomy, and the advent of tackers without evidence of sacral ostitis, VLS seems to be a simple, feasible, effective, and fast approach for treating POP.

Keywords

Sacrocolpopexy Laparoscopy Apical prolapse 

Notes

Compliance with ethical standards

Conflict of interest

None.

Supplementary material

ESM 1

(MPG 36676 kb)

ESM 2

(WMV 37493 kb)

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Copyright information

© The International Urogynecological Association 2017

Authors and Affiliations

  • Atef Darwish
    • 1
    Email author
  • Mostafa Bahlol
    • 1
  • AbdelGhafar Ahmad
    • 1
  • Mohamed Fekry
    • 1
  1. 1.Department of Obstetrics & GynecologyWomen’s Health University HospitalAssiutEgypt

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