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International Urogynecology Journal

, Volume 30, Issue 12, pp 2085–2092 | Cite as

Medium-term outcomes of laparoscopic sacropexy on symptoms and quality of life. Predictive factors for postoperative dissatisfaction

  • Anne-Cécile PizzoferratoEmail author
  • Marion Fermaut
  • Catalina Varas
  • Arnaud Fauconnier
  • Georges Bader
Original Article
  • 137 Downloads

Abstract

Introduction and hypothesis

We aimed to evaluate the medium-term results of laparoscopic sacropexy (LSP) with validated self-administered questionnaires of symptoms and quality of life and to identify pre-, intra-, and postoperative predictors of postoperative dissatisfaction.

Methods

The study included 152 women who had LSP for stage 2 or higher pelvic organ prolapse (POP). The study population comprised women who had completed the preoperative symptom questionnaire (including the PFDI-20 and ICIQ-SF). Postoperative questionnaires included those questionnaires as well as the PFIQ-7 and EQ-5D questionnaires, PISQ-12 sexual function questionnaire, and PGI-I questionnaire (to assess patient satisfaction).

Results

In all, 92 women (60.5%) responded in the postoperative period; 75 (81.5%) had anterior and posterior mesh and 17 (18.5%) anterior mesh alone. Moreover, 14 women (15.2%) had a concomitant suburethral sling and 18 (19.6%) a concomitant subtotal hysterectomy. The mean follow-up time was 50.5 (± 20.3) months (4.2 years). PFDI-20 scores had improved significantly at 4 years (median: 47.4 before surgery vs. 34.4 afterwards, p = 0.002), and patient satisfaction was quite clear (PGI-I score = 1.8 ± 1.1). Nine women (9.8%) described recurring vaginal bulge symptoms, and 12 patients were reoperated during follow-up. Recurrence [odds ratio (OR) 8.11, 95% confidence interval (95% CI) 2.28–28.9] and postoperative constipation (OR = 3.47, 95% CI 1.02–11.8) were strongly associated with poorer postoperative satisfaction, as was concomitant UI surgery (OR = 12.5, 95% CI 2.32–67.0).

Conclusions

LSP improved women’s symptoms and quality of life. Postoperative constipation, sensation of prolapse recurrence, and concomitant UI surgery were strongly associated with postoperative dissatisfaction.

Keywords

Laparoscopic sacropexy Pelvic organ prolapse Symptoms Satisfaction Quality of life 

Notes

Compliance with ethical standards

Conflicts of interest

None.

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Copyright information

© The International Urogynecological Association 2019

Authors and Affiliations

  1. 1.Department of Gynecology and ObstetricsUniversitary Hospital Center of CaenCaenFrance
  2. 2.Research Unit EA 7285 “Risk and Safety in Clinical Medicine for Women and Perinatal Health”Versailles-Saint-Quentin University (UVSQ)Montigny-le-BretonneuxFrance
  3. 3.Paris 13 University, Sorbonne Paris Cité, AP-HP, Jean-Verdier Hospital, Department of Obstetrics and GynecologyBondyFrance
  4. 4.Department of Gynecology and ObstetricsIntercommunal Hospital Center of Poissy-Saint-Germain-en-LayePoissyFrance

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