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Midterm comparison of laparoscopic high uterosacral ligament suspension and sacrocolpopexy in the treatment of moderate to severe apical prolapse

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Abstract

Introduction and hypothesis

The objective was to retrospectively analyze the midterm efficacy of laparoscopic high uterosacral ligament suspension (HUS) and sacrocolpopexy (SC) in the treatment of moderate to severe apical prolapse.

Methods

Patients who underwent laparoscopic HUS and SC in our center from 2013 to 2019 with follow-ups were included, consisting of laparoscopic HUS (group A, n=72) or SC (mesh added, group B, n=54). The general data of patients, pelvic organ prolapse quantitative examination (POP-Q) score, Pelvic Floor Distress Inventory short form 20 score (PFDI-20) before and after operation, perioperative conditions, Patient Global Impression of Improvement (PGI-I), and postoperative complications were collected for statistical analysis and comparison between groups.

Results

There was no statistical difference in preoperative data between groups. The median follow-up time was 48 months. The objective recurrence rate of group A was higher than that of group B, without statistical significance. One patient in group B had a second operation owing to recurrence. The exposure rate of mesh in group B was 3.70%. There was no significant difference in deviation of POP-Q and PFDI-20 pre- and post-operation. The proportion of new defecation abnormalities in group A was lower. The total hospitalization expenses and surgical consumables in group B were significantly higher than those in group A.

Conclusions

The midterm curative effect of laparoscopic HUS is similar to that of SC in the treatment of moderate to severe apical prolapse. The former has the advantages of less intraoperative blood loss, shorter postoperative hospital stay, lower cost, fewer new defecation abnormalities, and there were no complications related to mesh.

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Acknowledgement

We thank Liwen Bianji (Edanz) (www.liwenbianji.cn) for editing the English text of a draft of this manuscript.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Peking University Third Hospital, No.49 North Garden Street, 100191, Beijing, China

    Yiqi Guan, Kun Zhang, Jinsong Han, Ying Yao, Yiting Wang & Junfang Yang

Authors
  1. Yiqi Guan
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  2. Kun Zhang
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  3. Jinsong Han
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  4. Ying Yao
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  5. Yiting Wang
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  6. Junfang Yang
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Contributions

Y. Guan: data collection and management, data analysis; manuscript writing; K. Zhang: data collection, manuscript writing; J.S. Han: manuscript editing; Y. Yao: data collection; Y. Wang: surgeon; J. Yang: surgeon.

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Correspondence to Jinsong Han.

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This research has been approved by the Peking University Third Hospital Medical Science Research Ethics Committee (No. IRB00006761-M2022601, shown in supplementary materials)

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Guan, Y., Zhang, K., Han, J. et al. Midterm comparison of laparoscopic high uterosacral ligament suspension and sacrocolpopexy in the treatment of moderate to severe apical prolapse. Int Urogynecol J 34, 2501–2506 (2023). https://doi.org/10.1007/s00192-023-05552-y

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  • DOI: https://doi.org/10.1007/s00192-023-05552-y

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