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Preoperative ultrasound findings as risk factors of recurrence of pelvic organ prolapse after laparoscopic sacrocolpopexy

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Abstract

Introduction and hypothesis

The objective of this study is to evaluate levator ani muscle avulsion (LAMA) and ballooning as risk factors for recurrence of pelvic organ prolapse (POP) after laparoscopic sacrocolpopexy (SCP). We hypothesize that these ultrasound findings are associated with a higher risk of POP recurrence.

Methods

Retrospective cohort study of patients who underwent laparoscopic SCP between January 2015 and December 2018. Baseline translabial 3D ultrasound of the pelvic floor was performed. Pelvic Floor Distress Inventory (PFDI-20) and the Pelvic Floor Impact Questionnaire (PFIQ-7) were applied. Both univariate and multivariate analyses were carried out.

Results

One hundred thirty-four patients were included. On ultrasound, 32% of patients had levator ani muscle avulsion, and 36.5% had ballooning. Mean follow-up time was 16 months. There was a 13.4% anatomic recurrence; five of them (3.7%) also had symptomatic recurrence. After multivariate analysis we found that LAMA and ballooning were not significant: OR 0.99 (95% CI 0.098–10.1; p = 0.99) and OR 1.1 (95% CI 0.99–1.2; p = 0.06), respectively.

Conclusions

LAMA and ballooning on pelvic floor US are not significant risk factors for anatomic POP recurrence after laparoscopic SCP. Laparoscopic SCP has a 13.4% and 3.4% anatomic and symptomatic recurrence rate, respectively, and the majority of patients reported significant improvement in quality of life.

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Authors and Affiliations

  1. Obstetrics and Gynecology Department, Pontificia Universidad Católica de Chile, Pedro de Valdivia 150 Dept. 1321 Providencia, Santiago, Chile

    Fernanda Santis-Moya, Rodrigo Pineda & Victor Miranda

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  1. Fernanda Santis-Moya
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  2. Rodrigo Pineda
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  3. Victor Miranda
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Correspondence to Fernanda Santis-Moya.

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Santis-Moya, F., Pineda, R. & Miranda, V. Preoperative ultrasound findings as risk factors of recurrence of pelvic organ prolapse after laparoscopic sacrocolpopexy. Int Urogynecol J 32, 955–960 (2021). https://doi.org/10.1007/s00192-020-04503-1

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  • DOI: https://doi.org/10.1007/s00192-020-04503-1

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