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Clinical outcomes and complications of laparoscopic sacrocolpopexy with versus without concomitant hysterectomy for pelvic organ prolapse in Hong Kong Chinese patients after median follow-up of 7 years

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Abstract

Introduction and hypothesis

This retrospective cohort study is aimed at comparing outcomes and complications of laparoscopic sacrocolpopexy (LSC) with or without concomitant hysterectomy in the Hong Kong Chinese population.

Methods

Women with stage II or above uterine or apical vault prolapse who underwent LSC with or without concomitant hysterectomy in a regional referral unit from 2007 to 2019 were included. The primary objectives were to compare the anatomical outcomes by pelvic organ prolapse quantification system (POP-Q) and recurrence of apical vault prolapse (≥stage II). The secondary objective was to compare the functional outcomes and complications. Anatomical recurrence and incidence of mesh exposure were analyzed using the Kaplan–Meier method. Cox proportional hazard regression was performed to identify risk factors of anatomical recurrence.

Results

Seventy-six women were included for analysis. The recurrence rate of apical vault prolapse was 3.9% after a median follow-up time of 83 months (20–190 months). A significant reduction of POP-Q scores of three compartments in both groups of women were demonstrated (p<0.001). There was no difference between the two groups in terms of functional outcomes and complications. 6.6% of women developed mesh exposure. The time to recurrence of apical vault prolapse was shorter in women who had LSC with prior hysterectomy (p =0.019). No risk factors were identified for recurrence of apical vault prolapse.

Conclusions

Laparoscopic sacrocolpopexy with concomitant hysterectomy is comparable with LSC alone. The recurrence and complication rates are low. We suggest that LSC with concomitant hysterectomy might be offered to women with pelvic organ prolapse, with women’s preference taken into account.

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Acknowledgements

We thank Dr. Cecilia Willy Cheon and Dr. Cheung Ka Man for comments on the manuscript.

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Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, United Christian Hospital, Kwun Tong, Kowloon, Hong Kong

    Joyce Chung Yin Chan, Chun Hung Yu & Wing Wa Go

Authors
  1. Joyce Chung Yin Chan
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  2. Chun Hung Yu
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  3. Wing Wa Go
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Contributions

J.C.Y. Chan: data collection, data analysis, manuscript writing; C.H. Yu: protocol development, data collection, manuscript editing; W.W. Go: protocol development, data collection, manuscript editing.

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Correspondence to Joyce Chung Yin Chan.

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Chan, J.C.Y., Yu, C.H. & Go, W.W. Clinical outcomes and complications of laparoscopic sacrocolpopexy with versus without concomitant hysterectomy for pelvic organ prolapse in Hong Kong Chinese patients after median follow-up of 7 years. Int Urogynecol J 34, 271–278 (2023). https://doi.org/10.1007/s00192-022-05403-2

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  • DOI: https://doi.org/10.1007/s00192-022-05403-2

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