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Long-term safety, objective and subjective outcomes of laparoscopic sacrocolpopexy without peritoneal closure

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Abstract

Introduction and hypothesis

The laparoscopic sacrocolpopexy (LSC) is performed to support DeLancey’s level I in patients with pelvic organ prolapse (POP). Although several studies have been conducted on the safety, objective and subjective outcomes of LSC, the specific effect of retroperitonealisation of mesh is unknown. This study is aimed at analysing the safety, objective and subjective outcomes of the LSC without peritoneal closure of mesh.

Methods

The patients included have undergone an LSC for POP between 2004 and 2014. Retrospectively, a cohort of n = 178 was identified and asked to participate in a follow-up study. Chart research was performed. When informed consent was obtained, questionnaires were sent and the patients underwent a physical examination, including a POP-Q assessment. Each complication was scored by four reviewers for possibly being related to the non-peritonealisation of mesh.

Results

The data on the outcome cohorts were complete for safety n = 178, objective n = 124, and subjective n = 61. The Patient Global Impression of Improvement (PGI-I) score is provided in 106 questionnaires. In this study, 77 complications were observed in 49 different patients. The total success rate (no reoperation, no descent beyond the hymen and no bulging symptoms) is 59.0% with a median follow-up (IQR) of 35 months (18–51). Seventy-six patients (71.7%) described their condition as being (much) improved after LSC.

Conclusions

Three serious complications observed during the 178 LSCs were, by full consensus, thought to be possibly related to the non-peritonealisation of mesh. More than 70% of the patients found their condition to be (much) improved after the procedure.

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Acknowledgements

Institutions: Rijksuniversiteit Groningen; Diakonnessenhuis Utrecht en Zeist; Diakademie.

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Authors and Affiliations

  1. Diakonessenhuis Utrecht, Bosboomstraat 1, Utrecht, The Netherlands

    Crissie M. van den Akker & Piet C. Scholten

  2. st. Antonius Ziekenhuis, Koekoeklaan 1, 3435 CM, Nieuwegein, The Netherlands

    Wenche M. Klerkx

  3. Radboudumc Nijmegen, Geert Grooteplein Zuid 10, Nijmegen, The Netherlands

    Kirsten B. Kluivers

  4. Isala Zwolle, Dokter van Heesweg 2, Zwolle, The Netherlands

    Hugo W. F. van Eijndhoven

  5. Bergman Clinics, Prof. Bronkhorstlaan 10, 3723 MB, Bilthoven, The Netherlands

    Mariëlla I. J. Withagen

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  1. Crissie M. van den Akker
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  3. Kirsten B. Kluivers
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Correspondence to Wenche M. Klerkx.

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IUGA Annual Meeting, Vancouver, Canada, June 2017

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van den Akker, C.M., Klerkx, W.M., Kluivers, K.B. et al. Long-term safety, objective and subjective outcomes of laparoscopic sacrocolpopexy without peritoneal closure. Int Urogynecol J 31, 1593–1600 (2020). https://doi.org/10.1007/s00192-019-04020-w

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