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Long-term follow-up of laparoscopic sacrocolpopexy: comparison of two different techniques used in urology and gynecology

  • Adnan OrhanEmail author
  • Kemal Ozerkan
  • Hakan Vuruskan
  • Gokhan Ocakoglu
  • Isil Kasapoglu
  • Bahadir Koşan
  • Gurkan Uncu
Original Article
  • 40 Downloads

Abstract

Introduction and hypothesis

Numerous studies have found that the short-term results of laparoscopic sacrocolpopexy for pelvic organ prolapse are safe and effective. This study evaluates the long-term results of the laparoscopic sacrocolpopexy operation between the urology and gynecology branches.

Methods

A prospective study enrolling 206 patients was conducted to evaluate laparoscopic sacrocolpopexy as a surgical treatment for vaginal vault prolapse from 2011 to 2014. Two different surgical branches (urology and gynecology) applied laparoscopic sacrocolpopexy to their patients with their own techniques. The long-term results were assessed postoperatively after 4 years by pelvic examinations, including the Pelvic Organ Prolapse Quantification system (POP-Q) and quality-of-life assessments using validated questionnaires.

Results

A total of 190 patients (94 urology and 96 gynecology patients) received a full clinical follow-up examination between April 2014–June 2018. Postoperative pelvic organ prolapse recurrence rates in each compartment were similar in both groups during the 4 years; 87.2% of the urology and 86.5% of the gynecology patients had no prolapse in any compartment according to the POP-Q system. The reoperation rate was 5.3% for the urology and 6.2% for the gynecology group. Mesh erosion was detected in two patients in both groups. Three patients responded to local estrogen therapy, and we removed the mesh vaginally in one patient. The subjective cure rate was 89.4% in the urology and 88.5% in the gynecology group after 4 years.

Conclusions

Although different surgical branches perform laparoscopic sacrocolpopexy with their own techniques, long-term anatomical and functional results are similar between the branches. From a urogynecological point of view, laparoscopic sacrocolpopexy is a gold standard surgical procedure that can be performed by both urologists and gynecologists with similar long-term outcomes.

Keywords

Laparoscopic sacrocolpopexy Long-term follow-up Gynecology Urology 

Notes

Acknowledgments

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

Compliance wiht ethical standards

Conflicts of interest

None.

References

  1. 1.
    Wu JM, Hundley AF, Fulton RG, Myers ER. Forecasting the prevalence of pelvic floor disorders in US women: 2010 to 2050. Obstet Gynecol. 2009;114:1278.CrossRefGoogle Scholar
  2. 2.
    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.CrossRefGoogle Scholar
  3. 3.
    Cvach K, Dwyer P. Surgical management of pelvic organ prolapse: abdominal and vaginal approaches. World J Urol. 2012;30(4):471–7.  https://doi.org/10.1007/s00345-011-0776-y.CrossRefGoogle Scholar
  4. 4.
    Altman D, Väyrynen T, Engh ME, Axelsen S, Falconer C, et al. Anterior colporrhaphy versus transvaginal mesh for pelvic-organ prolapse. N Engl J Med. 2011;364(19):1826–36.CrossRefGoogle Scholar
  5. 5.
    Nieminen K, Hiltunen R, Takala T, Heiskanen E, Merikari M, Niemi K, et al. Outcomes after anterior vaginal wall repair with mesh: a randomized, controlled trial with a three-year follow-up. Am J Obstet Gynecol. 2010;203(3):235.e1–8.CrossRefGoogle Scholar
  6. 6.
    Nguyen JN, Burchette RJ. Outcome after anterior vaginal prolapse repair: a randomized controlled trial. Obstet Gynecol. 2008;111(4):891–8.CrossRefGoogle Scholar
  7. 7.
    UPDATE on Serious Complications Associated with Transvaginal Placement of Surgical Mesh for Pelvic Organ Prolapse, FDA, July 2011 https://www.fda.gov/downloads/medicaldevices/safety/alertsandnotices/ucm262760.pdf. Accessed 26 Oct 2018.
  8. 8.
    Gomelsky A, Dmochowski RR. Vaginal mesh update. Curr Opin Urol. 2012;22(4):271–5.CrossRefGoogle Scholar
  9. 9.
    Coolen AWM, van Oudheusden AMJ, Mol BWJ, van Eijndhoven HWF, Roovers JWR, Bongers MY. Laparoscopic sacrocolpopexy compared with open abdominal sacrocolpopexy for vault prolapse repair: a randomized controlled trial. Int Urogynecol J. 2017;28(10):1469–79.CrossRefGoogle Scholar
  10. 10.
    Geller EJ, Siddiqui NY, Wu JM, Visco AG. Short-term outcomes of robotic sacrocolpopexy compared with abdominal sacrocolpopexy. Obstet Gynecol. 2008;112:1201.CrossRefGoogle Scholar
  11. 11.
    Lane FE. Repair of posthysterectomy vaginal-vault prolapse. Obstet Gynecol. 1962;20:72–7.CrossRefGoogle Scholar
  12. 12.
    Anand M, Weaver AL, Fruth KM, et al. Perioperative complications and cost of vaginal, open abdominal, and robotic surgery for apical vaginal vault prolapse. Female Pelvic Med Reconstr Surg. 2017;23:27.CrossRefGoogle Scholar
  13. 13.
    Maher C, Feiner B, Baessler K, Schmid C. Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev. 2013:CD004014.Google Scholar
  14. 14.
    De Gouveia De Sa M, Claydon LS, Whitlow B, Dolcet Artahona MA. Laparoscopic versus open sacrocolpopexy for treatment of prolapse of the apical segment of the vagina: a systematic review and meta-analysis. Int Urogynecol J. 2016;27(1):3–17.CrossRefGoogle Scholar
  15. 15.
    Patel M, O’Sullivan D. Tulikangas PK. A comparison of costs for abdominal, laparoscopic, and robot-assisted sacral colpopexy. Int Urogynecol J Pelvic Floor Dysfunct. 2009;20:223.CrossRefGoogle Scholar
  16. 16.
    Judd JP, Siddiqui NY, Barnett JC, et al. Cost-minimization analysis of robotic-assisted, laparoscopic, and abdominal sacrocolpopexy. J Minim Invasive Gynecol. 2010;17:493.CrossRefGoogle Scholar
  17. 17.
    Freeman RM, Pantazis K, Thomson A, Frappell J, Bombieri L, Moran P, et al. A randomized controlled trial of abdominal versus laparoscopic sacrocolpopexy for the treatment of post-hysterectomy vaginal vault prolapse: LAS study. Int Urogynecol J. 2013;24(3):377–84.CrossRefGoogle Scholar
  18. 18.
    Paraiso MF, Jelovsek JE, Frick A, et al. Laparoscopic compared with robotic sacrocolpopexy for vaginal prolapse: a randomized controlled trial. Obstet Gynecol. 2011;118:1005.CrossRefGoogle Scholar
  19. 19.
    Anger JT, Mueller ER, Tarnay C, et al. Robotic compared with laparoscopic sacrocolpopexy: a randomized controlled trial. Obstet Gynecol. 2014;123:5.CrossRefGoogle Scholar
  20. 20.
    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;175(1):10–7.CrossRefGoogle Scholar
  21. 21.
    Kaplan PB, Sut N, Sut HK. Validation, cultural adaptation and responsiveness of two pelvic-floor-specific quality-of-life questionnaires, PFDI-20 and PFIQ-7, in a Turkish population. Eur J Obstet Gynecol Reprod Biol. 2012;162(2):229–33.CrossRefGoogle Scholar
  22. 22.
    Coolen AWM, Bui BN, Dietz V, Wang R, van Montfoort APA, Mol BWJ, et al. The treatment of post-hysterectomy vaginal vault prolapse: a systematic review and meta-analysis. Int Urogynecol J. 2017;28(12):1767–83.CrossRefGoogle Scholar
  23. 23.
    Maher CF, Feiner B, DeCuyper EM, Nichlos CJ, Hickey KV, O’Rourke P. Laparoscopic sacral colpopexy versus total vaginal mesh for vaginal vault prolapse: a randomized trial. Am J Obstet Gynecol. 2011;204(4):360.e1–7.CrossRefGoogle Scholar
  24. 24.
    Sarlos D, Kots L, Ryu G, Schaer G. Long-term follow-up of laparoscopic sacrocolpopexy. Int Urogynecol J. 2014;25(9):1207–12.CrossRefGoogle Scholar
  25. 25.
    Hilger WS, Poulson M, Norton PA. Long-term results of abdominal sacrocolpopexy. Am J Obstet Gynecol. 2003;189:1606.CrossRefGoogle Scholar
  26. 26.
    Nygaard I, Brubaker L, Zyczynski HM, et al. Long-term outcomes following abdominal sacrocolpopexy for pelvic organ prolapse. JAMA. 2013;309:2016.CrossRefGoogle Scholar
  27. 27.
    Trabuco EC, Linder BJ, Klingele CJ, Blandon RE, Occhino JA, Weaver AL, et al. Two-year results of Burch compared with midurethral sling with sacrocolpopexy: a randomized controlled trial. Obstet Gynecol. 2018;131(1):31–8.CrossRefGoogle Scholar
  28. 28.
    Nygaard IE, McCreery R, Brubaker L. Abdominal sacrocolpopexy: a comprehensive review. Obstet Gynecol. 2004;104:805.CrossRefGoogle Scholar
  29. 29.
    Nair R, Nikolopoulos KI, Claydon LS. Clinical outcomes in women undergoing laparoscopic hysteropexy: a systematic review. Eur J Obstet Gynecol Reprod Biol. 2017;208:71.CrossRefGoogle Scholar
  30. 30.
    Jeon MJ, Jung HJ, Choi HJ, et al. Is hysterectomy or the use of graft necessary for the reconstructive surgery for uterine prolapse? Int Urogynecol J Pelvic Floor Dysfunct. 2008;19:351.CrossRefGoogle Scholar

Copyright information

© The International Urogynecological Association 2019

Authors and Affiliations

  1. 1.Department of Obstetrics and GynecologyUludag University HospitalBursaTurkey
  2. 2.Department of UrologyUludag University HospitalBursaTurkey
  3. 3.Department of BiostatisticsUludag University HospitalBursaTurkey

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