Comparison of laparoscopic high and vaginal uterosacral ligament suspension in the management of apical prolapse

Sezgin, Burak; Kıncı, Mehmet Ferdi; Akbaba, Eren; Akin, Melike Nur; Gökbel, İsmail; Sivaslıoğlu, Ahmet Akın

doi:10.34057/ppj.2021.40.04.2021-10-3

Cited by 3 publications

(3 citation statements)

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“…Recurrence rate of symptomatic prolapse was higher in the V-USLS group (41% vs. 24%, p = 0.046); however, retreatment rate was similar in the two groups (0% vs. 7%, p = 0.113). In Sezgin 2021 ( 18 ), L-USLS and V-USLS groups were similar in distribution, age, BMI, and comorbidities with no significant statistical difference. The mean follow-up was 12 months for both groups.…”

Section: Resultsmentioning

confidence: 87%

“…The mean blood loss is 106.8 mL (range 50–200 mL). Chill 2020 ( 21 ) and Sezgin 2021 ( 18 ) were the two studies that had not analyzed the former data. Overall, intraoperative complications are described only in two cases in Turner 2015 ( 16 ) with a rate of 2.7%, including six cases of ureteral injury recognized intraoperatively and treated by stent placement.…”

Section: Resultsmentioning

confidence: 99%

“…Afterward, records with no full text, lack of outcomes of interest, and wrong study designs (e.g., reviews or case report) were excluded. At the end of this selection, nine studies were suitable for eligibility and matched the inclusion criteria: two articles were single-armed, non-comparative retrospective observational studies, which evaluate the surgical procedure and outcomes of laparoscopic uterosacral ligament suspension (13,14); four studies were comparative retrospective cohort studies that analyze the data about laparoscopic and vaginal USLS (15)(16)(17)(18); and three more articles were comparative studies where laparoscopic USLS was confronted with other surgical techniques (19)(20)(21). From the aforementioned articles, we only extracted data about patients that had undergone laparoscopic USLS and laparoendoscopic single-site ULSL (Figure 1).…”

Section: Studies' Characteristicsmentioning

confidence: 99%

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Laparoscopic uterosacral ligament suspension: a systematic review and meta-analysis of safety and durability

Ronsini¹,

Pasanisi²,

Cianci³

et al. 2023

Front. Surg.

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IntroductionPelvic organ prolapse (POP) is a widespread condition affecting from 40% to 60% of women. Reconstructive vaginal surgeries are the most commonly performed procedures to treat POP. Among those, uterosacral ligament suspension (USLS), which is usually performed transvaginally, preserves pelvic statics and dynamics and appears to be an effective method. Laparoscopic USLS is a valid alternative to vaginal approach, and the aim of our review is to confirm its safety and feasibility and to compare clinical outcomes among the procedures.Materials and methodsFollowing the recommendations in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, we systematically searched the PubMed and Scopus databases in December 2022. We made no restriction on the publication year nor on the country. Data about POP-Q recurrence rate (RR), intraoperative and postoperative complications (graded according to Clavien–Dindo classification), readmission rate, and reoperation rate were collected and analyzed. We used comparative studies for meta-analysis.ResultsA total of nine studies fulfilled inclusion criteria: two articles were non-comparative retrospective observational studies, three more articles were comparative studies where laparoscopic USLS was confronted with other surgical techniques (only data of laparoscopic USLS were analyzed), and four were comparative retrospective cohort studies between laparoscopic and vaginal USLS procedures. The comparative studies were enrolled in meta-analysis. Patients were analyzed concerning perioperative risks and the risk of recurrence. The meta-analysis highlighted that there was no clear inferiority of one technique over the other.DiscussionLaparoscopic USLS is a technique with a low complication rate and low recurrence rate. Indeed, laparoscopic procedure allows better identification of anatomical landmarks and access to retroperitoneum. Moreover, efficacy over time and durability of Laparoscopic (LPS) USLS was also observed. However, these data should be weighed in light of the length of follow-up, which was in a very short range. Further, focused and prospective studies will be necessary to confirm this finding.

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Section: Resultsmentioning

confidence: 87%