Laparoscopic hysteropexy: a novel technique for uterine preservation surgery

Rahmanou, Philip; Price, Natalia; Jackson, Sonia

doi:10.1007/s00192-013-2129-4

Cited by 20 publications

(17 citation statements)

References 4 publications

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“…The peritoneum was opened over the sacral promontory and right pelvic sidewall between the ureter and rectum toward the pouch of Douglas [7]. Each broad ligament at the level of the cervicouterine junction was also opened through the avascular area and the bladder dissected distally.…”

Section: Interventionsmentioning

confidence: 99%

“…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: Interventionsmentioning

confidence: 99%

“…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 technique for the laparoscopic sacrohysteropexy is modified from the ‘Oxford hysteropexy’ . All patients undertook a clear fluid diet, bowel preparation in the evening prior to surgery, and 400 µg of misoprostol vaginally two hours pre‐operatively.…”

Section: Methodsmentioning

confidence: 99%

Success rates and outcomes of laparoscopic mesh sacrohysteropexy

Daniels

Robson

Palacz

et al. 2019

Aust NZ J Obst Gynaeco

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Background: Uterovaginal prolapse is a prevalent gynaecological issue, which can have a negative impact on the quality of life of women. Hysterectomy and vaginal repair are conventional treatments to address apical prolapse; however, women are increasingly requesting uterine-preserving alternatives. Aims:This study aimed to evaluate the impact of laparoscopic mesh sacrohysteropexy on symptomatic prolapse from an Australian experience. Materials and Methods: This retrospective cohort study presents outcomes of 157 patients who underwent laparoscopic mesh sacrohysteropexy at a private practice in South Australia during 2007-2017. Primary outcome is the success rate according to the pelvic organ prolapse quantification (POP-Q) system. Secondary measures included complication rates and patients identified as having Stages III-IV prolapse and their outcomes. Results: The median age was 58 years (27-86 years), median parity was 2 (0-6), and median body mass index was 26.8 (23-29.9). One hundred and thirty-four women had a laparoscopic hysteropexy and concurrent vaginal prolapse repair and four women had an isolated laparoscopic hysteropexy. The mean pre-operative point C was 0.60. The mean change from pre-operative point C to post-operative point C was 7.6 cm (P < 0.01). Of the 136 patients (98.6%) seen at post-operative 4-6 weeks, all had Stage 0 POP-Q scores. Prolapse recurrence was observed in 22 patients, while 116 patients remained cured at their last follow-up. Prolapse recurrence was associated with anterior vaginal mesh, previous prolapse surgery, pre-operative Stage III-IV disease and number of vaginal deliveries. Conclusions: Laparoscopic mesh sacrohysteropexy is an effective and safe procedure with a high success rate comparable to available international data. K E Y W O R D S laparoscopy, pelvic organ prolapse, surgical mesh, uterus, vagina

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“…The technique previously reported from Oxford [ 1 ] entails complete cervical encirclage with polypropylene; a video describing this technique has been published [ 2 ]. A three or four port laparoscopic approach is used.…”

Section: Introductionmentioning

confidence: 99%

Pregnancy following laparoscopic hysteropexy—a case series

2017

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BackgroundUterine-preserving prolapse surgery offers the chance to retain fertility; however, limited data is available for the safety of pregnancy following surgery and the effect of pregnancy on surgical outcome. Our operative technique involves mesh encircling the cervix and uterine arteries, which raises concerns that compromise of uterine blood flow during pregnancy may lead to foetal growth restriction. We also think this necessitates delivery by caesarean section. We report on six pregnancy outcomes following laparoscopic hysteropexy. Primary outcomes were live birth and birth weight. Secondary outcomes were integrity of mesh and immediate effect on prolapse.ResultsAll patients had successful pregnancy outcomes with birth weights on or above the 10th centile. There was no effect on mesh integrity seen in any of the cases. There was no deterioration in apical prolapse when assessed post delivery, but two patients had new onset anterior vaginal wall prolapse.ConclusionsWe think our technique of hysteropexy is safe for those wishing to conceive. Larger numbers are needed to allow robust evidence-based guidance for patients and clinicians.

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Laparoscopic hysteropexy: a novel technique for uterine preservation surgery

Abstract: This procedure, apart from possible preservation of fertility in younger women, provides strong apical support, which should be long lasting. The other advantages of laparoscopic surgery are quicker recovery, less pain and better cosmesis.

Cited by 20 publications

References 4 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

Success rates and outcomes of laparoscopic mesh sacrohysteropexy

Pregnancy following laparoscopic hysteropexy—a case series

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