Medium-term outcomes of laparoscopic sacropexy on symptoms and quality of life. Predictive factors for postoperative dissatisfaction
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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.
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).
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).
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.
KeywordsLaparoscopic sacropexy Pelvic organ prolapse Symptoms Satisfaction Quality of life
Compliance with ethical standards
Conflicts of interest
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