Laparoscopic inguinal ligament suspension combined with hysterectomy for the treatment of uterovaginal prolapse

Abstract

Aim: To demonstrate the efficacy and safety of a modified technique of laparoscopic inguinal ligament suspension (LILS) with hysterectomy for the treatment of uterovaginal prolapse. Methods: A total of 57 patients were treated by LILS combined with hysterectomy between Jan 2014 and Feb 2016. The perioperative parameters, such as operative time, estimated blood loss, length of stay and intra-and postoperative complications were recorded. The Pelvic Organ Prolapse questionnaire classification was applied to evaluate the Pelvic Organ Prolapse stage, and Patient Global Impression of Improvement scale was used to determine the patients' satisfaction. Pelvic Floor Distress Inventory-20 and Pelvic Floor Impact Questionnaire were used to evaluate the functional improvement. All data were collected preoperatively and then at 12 months postoperatively. Results: The mean surgical time was 130.4 (82-190) min, the average blood loss was 50.4 (10-300) mL and the mean hospitalization was 5.3 (4-8) days. The rates of intra-and postoperative complications were low. After a minimal of 12 months follow-up, the anatomical success rate was 85.5%, and the subjective satisfaction rate was 92.7%. The functional measures also presented a significant improvement with no recurrence of prolapse. Conclusion: LILS combined with hysterectomy was a safe and effective technique and might be considered as an alternative treatment for patients with uterovaginal prolapse.

A commentary on ‘Laparoscopic inguinal ligament suspension with uterine preservation for pelvic organ prolapse: a retrospective cohort study’

“…Symptoms of pelvic organ prolapse (POP) affect 6–8% of individuals, which is a disorder that negatively impacts patients’ quality of life 1 . Depending on whether the vagina is preserved, POP surgery is classified as reconstructive surgery or colpocleisis, including typical vaginal wall repair, transvaginal mesh-based repair, sacrospinous ligament fxation high uterosacral ligament suspension, and sacrocolpopexy 2 . A portion of the surgery typically results in a number of problems, such as nonphysiological placement, vascular issues, and incursion into the region of the retroperitoneal nerve plexuses 3 .…”