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Transvaginal single-port laparoscopic pelvic reconstruction with Y-shaped mesh: experiences of 93 cases

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Abstract

Introduction and hypothesis

To demonstrate the outcomes of pelvic reconstruction using Y-shaped mesh in patients with multiple-compartment pelvic organ prolapse via transvaginal single-port laparoscopy.

Methods

We conducted a retrospective case series study. Patients diagnosed with severe multiple-compartment prolapse were enrolled between July 1, 2017, and March 31, 2020. Patients underwent transvaginal single-port laparoscopic pelvic reconstruction with Y-shaped mesh. Baseline data and perioperative results were collected. Patients were followed up with the POP-Q score, Pelvic Floor Distress Inventory (PFDI-20) and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire short form (PISQ-12). T-test was used for statistical analysis.

Results

Operations were successful in all 93 patients without conversion or serious complications. Mean operative time was 132.70 ± 28.02 min and estimated blood loss was 110.65 ± 56.31 ml. VAS pain score was 2.91 ± 1.16 and cosmetic score was 9.20 ± 0.60. During 1–33 months of follow-up, no recurrence or mesh exposure was observed. Five patients suffered from de novo SUI, six had constipation, two had dyspareunia, and one had persistent pelvic pain. The pre- and postoperative Aa point was +2.13 ± 1.23 vs. −2.91 ± 0.28 (P < 0.05), C point was 2.63 ± 2.41 vs. -6.86 ± 0.69 (P < 0.05), and Ap point was −0.26 ± 1.79 vs. −2.97 ± 0.16 (P < 0.05). The PFDI-20 score was 76.81 ± 32.06 vs. 18.18 ± 20.25 (P < 0.05), while the PISQ-12 score was 34.30 ± 4.17 vs. 37.20 ± 2.60 (P < 0.05), which suggested significant improvements in both physical prolapse and quality of life after surgery.

Conclusion

Transvaginal single-port laparoscopic pelvic reconstruction with Y-shaped mesh is a feasible, effective and safe treatment option for severe multiple-compartment prolapse. Patients may benefit from its mild pain level and good cosmetic effect as well as only minor mesh-related complications.

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Acknowledgements

We appreciate the funding from the China Preventive Medicine Association (grant no. 201809030).

Funding

China Preventive Medicine Association (grant no. 201809030).

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Author notes

  1. Junwei Li and Changdong Hu contributed equally to this work.

Authors and Affiliations

  1. Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, 128 Shenyang Road, Shanghai, 200090, China

    Junwei Li, Changdong Hu, Xiaojuan Wang, Keqin Hua & Yisong Chen

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  1. Junwei Li
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  2. Changdong Hu
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  3. Xiaojuan Wang
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  4. Keqin Hua
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Contributions

Junwei Li: patient recruitment, data collection and analysis, manuscript writing.

Changdong Hu: data collection and analysis, statistical analysis, manuscript writing.

Xiaojuan Wang: patient recruitment, data collection.

Keqin Hua: study design, patient recruitment, data collection.

Yisong Chen: study design, patient recruitment, responsible surgeon.

Corresponding authors

Correspondence to Keqin Hua or Yisong Chen.

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Li, J., Hu, C., Wang, X. et al. Transvaginal single-port laparoscopic pelvic reconstruction with Y-shaped mesh: experiences of 93 cases. Int Urogynecol J 32, 905–911 (2021). https://doi.org/10.1007/s00192-020-04418-x

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