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The vaginally assisted laparoscopic sacrocolpopexy: a pilot study

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Abstract

Introduction and hypothesis

We assessed the efficacy and safety of an operative technique, the vaginally assisted laparoscopic sacrocolpopexy (VALS), for the treatment of women with severe uterovaginal prolapse (UVP).

Methods

A prospective pilot study of women with severe UVP, who underwent VALS, was carried out. Preoperatively, POP was assessed using the International Continence Society Pelvic Organ Prolapse Quantification (ICS POP-Q) system and symptoms were evaluated using the International Consultation on Incontinence Modular Questionnaire-Vaginal Symptoms (ICIQ-VS). VALS is a combined minimally invasive surgical approach where a vaginal hysterectomy is initially performed, followed by a transvaginal placement of a synthetic mesh which is suspended laparoscopically on the sacral promontory. Postoperative assessment at 12 months was identical to the preoperative assessment with the addition of the Patient Global Impression of Improvement (PGI-I) for urogenital prolapse. Perioperative and postoperative complications were recorded.

Results

Twenty-seven women with a mean age of 57.2 (range, 47–73) were included. Twenty women (74.1%) had stage 3 and 7 (25.9%) had stage 4 POP with a median point C = +5 (range, +2 to +8). VALS was successfully performed in all patients. All patients completed their follow-up assessment at 12 months. All POP-Q points showed statistically significant improvement apart from TVL, which remained unchanged. ICIQ-VS scores showed a statistically significant improvement of the vaginal symptoms and the total quality of life. The sexual matters score showed a tendency towards improvement, although it did not reach statistical significance.

Conclusions

Vaginally assisted laparoscopic sacrocolpopexy appears to be a valid and safe minimally invasive option when treating women presenting with severe UVP, with encouraging short-term anatomical and functional outcomes.

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Abbreviations

SCP:

Sacrocolpopexy

MUS:

Midurethral slings

ICIQ-VS:

International Consultation on Incontinence Modular Questionnaire-Vaginal Symptoms

POP-Q:

Pelvic Organ Prolapse Quantification

VH:

Vaginal hysterectomy

PGI-I:

Patient Global Impression of Improvement

UVP:

Uterovaginal prolapse

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Conflicts of interest

Stavros Athanasiou: received travel expenses from Johnson&Johnson; Themos Grigoriadis: received travel expenses from Johnson&Johnson; Ioannis Chatzipapas: none; Athanasios Protopapas: none; Aris Antsaklis: none.

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Authors and Affiliations

  1. First Department of Obstetrics & Gynecology, Urogynecology Unit, University of Athens, 98A Vas. Sofias Avenue, 11528, Athens, Greece

    Stavros Athanasiou & Themos Grigoriadis

  2. First Department of Obstetrics & Gynecology, University of Athens, Athens, Greece

    Ioannis Chatzipapas, Athanasios Protopapas & Aris Antsaklis

Authors
  1. Stavros Athanasiou
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  2. Themos Grigoriadis
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  3. Ioannis Chatzipapas
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  4. Athanasios Protopapas
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  5. Aris Antsaklis
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Corresponding author

Correspondence to Stavros Athanasiou.

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Athanasiou, S., Grigoriadis, T., Chatzipapas, I. et al. The vaginally assisted laparoscopic sacrocolpopexy: a pilot study. Int Urogynecol J 24, 839–845 (2013). https://doi.org/10.1007/s00192-012-1947-0

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  • DOI: https://doi.org/10.1007/s00192-012-1947-0

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