Laparoscopic hysteropexy: 1- to 4-year follow-up of women postoperatively

Rahmanou, Philip; White, Brent C.; Price, Natalia; Jackson, Sonia

doi:10.1007/s00192-013-2209-5

Cited by 50 publications

(38 citation statements)

References 26 publications

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“…Objective assessment showed significant improvement in point C, which was elevated by a mean of 6.8 cm. This was very similar to our previous observational study of a larger cohort [9]. We suspect that the polypropylene mesh used will provide more durable longterm apical support in the LH group.…”

Section: Discussionsupporting

confidence: 77%

“…The mesh is completely reperitonealized to reduce the risk of bowel adhesions. The procedure was fully described and also presented as a video article in previous publications [7][8][9].…”

Section: Interventionsmentioning

confidence: 99%

“…The Oxford laparoscopic hysteropexy technique used in this study has been previously reported; early and intermediate observational prospective studies have shown that it is an effective and safe operation for uterine prolapse preservation surgery [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

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Laparoscopic hysteropexy versus vaginal hysterectomy for the treatment of uterovaginal prolapse: a prospective randomized pilot study

2015

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Section: Discussionsupporting

confidence: 77%

“…The mesh is completely reperitonealized to reduce the risk of bowel adhesions. The procedure was fully described and also presented as a video article in previous publications [7][8][9].…”

Section: Interventionsmentioning

confidence: 99%

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Laparoscopic hysteropexy versus vaginal hysterectomy for the treatment of uterovaginal prolapse: a prospective randomized pilot study

2015

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“…The most frequent complications, both early and late, were constipation and urinary tract infection with cumulative rates of 8.9 and 19.6%, respectively. These are both common complications of prolapse surgery, as shown in a younger cohort undergoing hysteropexy where rates were 12.9% for constipation and 2.9% for UTI are reported [10]. Whilst the incidences of both of these complications were increased in our more elderly cohort, elderly patients in general have a greater frequency of constipation and UTI.…”

Section: Discussionsupporting

confidence: 48%

Laparoscopic uterovaginal prolapse surgery in the elderly: feasibility and outcomes

et al. 2017

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BackgroundUterovaginal prolapse in very elderly women is a growing problem due to increased life expectancy. Surgeons and anaesthetists may be wary of performing quality of life surgery on this higher risk group. Where surgery is undertaken, it is commonly performed vaginally; there is a perception that this is better tolerated than abdominal surgery.Little data is published about laparoscopic prolapse surgery tolerability in this population, and laparoscopic surgery is perceived within the urogynaecological community as complex and lengthy and hence inherently unsuitable for the very elderly.In Oxford, UK, laparoscopic abdominal surgical techniques are routinely employed for urogynaecological reconstructive surgery. The authors offer abdominal laparoscopic prolapse surgery to patients suitable for general anaesthesia with apical vaginal prolapse, irrespective of age. We here report outcomes in this elderly patient cohort and hypothesise these to be acceptable.This is a retrospective case note review of all patients aged 79 years old and above undergoing laparoscopic prolapse surgery (hysteropexy or sacrocolpopexy) in two centres in Oxford, UK, over a 5-year period (n = 55). Data were collected on length of surgery, length of stay, intraoperative complications, early and late post-operative complications and surgical outcome.ResultsMean age was 82.6 years (range 79–96). There were no deaths. Minor post-operative complications such as UTI and constipation were frequent, but there were no serious (Clavien-Dindo grade III or above) complications; 80% achieved objective good anatomical outcome.ConclusionsLaparoscopic prolapse surgery appears well tolerated in the elderly with low operative morbidity and mortality.

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“…The award for best abstract [4] went to Dr. Corina Schmid, who presented the updated 2012 Cochrane review for surgical management of POP. The best video presentation [23] went to Dr. Philip Rahmanou who presented his unit's experience in laparoscopic hysteropexy in women with 1-4 years follow-up.…”

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confidence: 99%

Highlights of IUGA 37th annual meeting in Brisbane 2012

2013

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It was a long journey for most of the international delegates who came to Brisbane, Australia for the 37th International Urogynecological Association (IUGA) annual scientific meeting this year. Despite the distance, there was not sufficient time to digest all the abstracts in-flight. Indeed, 17 nations were represented, with 1,400 delegates attending the 2012 IUGA. There were 21 workshops in the first 2 days, 7 state-of-the-art roundtable addresses and debates, 96 podium/video presentations, and 228 poster presentations. The meeting began with interactive workshops which were all popular, especially Abdul Sultan's anal sphincter repair, the 3 ultrasound workshops, the anatomy cadaver workshop with John DeLancey, and the Urogynaecological Society of Australasia (UGSA) live surgery demonstration chaired by Mickey Karram and Malcolm Fraser.The extensive scientific program, which also included the European Urogynecological Association (EUGA) surgical course and Ibero-American urogynecology session, catered to a variety of experience and educational needs. The complementary nature and high caliber of the scientific program was evident. Basic science communications gave an overview of current research interests including one describing the effects of cyclic mechanical loading on fibroblasts from women with different Pelvic Organ Prolapse Quantification (POP-Q) stage [1]. High-quality studies followed with two randomized controlled trials on the most controversial topic of the day: the mesh repair [2,3] and a Cochrane review [4] which was awarded best abstract. Further surgical studies included one where the classical Richter suspension (vaginal sacrospinous fixation) at hysterectomy had a higher failure rate in patients with levator injury and was significantly inferior to the mesh procedure [5] and another where better anatomical and functional success rates were reported with mesh compared with traditional anterior colporrhaphy [2]. Surgical procedures were assessed on quality of life [6] and symptoms [7] with greater emphasis on these than anatomical results, highlighting the importance of subjective outcomes. Nonrandomized controlled studies included, for example, in the surgical complication category, the importance of diagnosis of intraoperative visceral injury to the bladder with the methylene blue test and digital rectal exam in vaginal surgery [8,9]. An elegant demonstration of abdominal prolapse repair with robotic assistance was shown in the video category [10]. The category of urinary dysfunction included topics such as "Does surgery for urinary incontinence in women affect their use of symptomrelieving medications?" [11], musculoskeletal pain evaluation of patients with interstitial cystitis [12], and a systematic review of bulking agents for urinary incontinence [13].A wide range of conservative therapies were evaluated, including the safe and effective use of pessary over a median duration of 35 months [14], a prospective multicenter study of solifenacin for overactive bladder [15], and the role of perc...

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Laparoscopic hysteropexy: 1- to 4-year follow-up of women postoperatively

Abstract: Laparoscopic hysteropexy is a safe and effective treatment. The 1- to 4-year outcome suggests high patient satisfaction and low rates of apical prolapse recurrence. Longer term follow-up and randomized controlled studies are required.

Cited by 50 publications

References 26 publications

Laparoscopic hysteropexy versus vaginal hysterectomy for the treatment of uterovaginal prolapse: a prospective randomized pilot study

Laparoscopic hysteropexy versus vaginal hysterectomy for the treatment of uterovaginal prolapse: a prospective randomized pilot study

Laparoscopic uterovaginal prolapse surgery in the elderly: feasibility and outcomes

Highlights of IUGA 37th annual meeting in Brisbane 2012

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