Laparoscopic sacral hysteropexy versus laparoscopic sacral colpopexy plus supracervical hysterectomy in patients with pelvic organ prolapse

Campagna, Giuseppe; Vacca, Lorenzo; Panico, Giovanni; Rumolo, Valerio; Caramazza, Daniela; Lombisani, Andrea; Rossitto, Cristiano; Gadonneix, P.; Scambia, Giovanni; Ercoli, Alfredo

doi:10.1007/s00192-021-04865-0

Cited by 27 publications

(40 citation statements)

References 27 publications

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“…With the rapid and continuous development of medical science and technology in China, laparoscopic technology has been widely used in clinical practice. And, laparoscopic high uterosacral ligament suspension is more safe and reliable for uterine prolapse [ 5 , 6 ]. On account of this, our two hospitals performed laparoscopic total hysterectomy combined with high hysterosacral ligament suspension for patients with uterine prolapse but no willingness to retain the uterus, which had an ideal effect.…”

Section: Introductionmentioning

confidence: 99%

Analysis on Effects of Laparoscopic Total Hysterectomy Combined with High Hysterosacral Ligament Suspension in the Treatment for Uterine Prolapse

Qiu

Wang

Chen

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Objective. To investigate the effect of laparoscopic total hysterectomy combined with high hysterosacral ligament suspension on the treatment for uterine prolapse. Methods. A total of 100 patients with uterine prolapse treated in our two hospitals from January 2019 to December 2021 were included in this study, which were divided into two groups through the number double-blind method, with 50 patients in each group. The control group was treated with transvaginal total hysterectomy, and the research group was treated with laparoscopic total hysterectomy combined with high hysterosacral ligament suspension. The surgical effect on patients was evaluated through the pelvic organ prolapse quantification method (POP-Q). The patients’ adverse reactions were compared. The quality of sexual life was evaluated with the short form of the pelvic organ prolapse/urinary incontinence sexual questionnaire (PISQ-31). And, the patients’ quality of life was also evaluated with the pelvic floor distress inventory-short form 20 (PFDl-20). Results. The surgical effect on the control group and the research group was 80.00% and 96.00%, respectively, with statistical significance (X2 = 6.601, P < 0.001 ). The incidences of adverse reactions of the two groups were 4.00% and 6.00%, respectively, which were comparable (X2 = 0.211, P = 0.646 ). The total PISQ-31 scores before surgery of the control group (97.07 ± 9.80) and the research group (97.02 ± 9.80) were comparable (t = 0.020, P = 0.984 ), and those after surgery were 112.55 ± 13.78 in the control group and 130.80 ± 17.42 in the research group, respectively, with statistical significance (t = 4.500, P < 0.001 ). And, the total PFDl-20 scores before surgery of the control group (72.50 ± 13.58) and the research group (72.50 ± 13.60) were comparable (t = 0.057, P = 0.098 ), and that after surgery were 56.10 ± 10.51 in the control group and 42.30 ± 8.05 in the research group, respectively, with statistical significance (t = 5.709, P < 0.001 ). Conclusion. Laparoscopic total hysterectomy combined with high hysterosacral ligament suspension has an ideal effect in patients with uterine prolapse, with few adverse reactions, effectively promoting the improvement of the quality of patients’ sexual life and their life. This combination has the significance of active promotion in the clinic.

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Section: Introductionmentioning

confidence: 99%

Analysis on Effects of Laparoscopic Total Hysterectomy Combined with High Hysterosacral Ligament Suspension in the Treatment for Uterine Prolapse

Qiu

Wang

Chen

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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“…13 A recent study by Campagna et al,14 shows the efficacy of laparoscopic sacrocolpopexy in managing POP recurrence in patients with the previous history of trans vaginal polypropylene mesh surgery and another study by the latter shows the effectiveness of laparoscopic sacrocolpopexy with or without supracervical hysterectomy in previously non-hysterectomized patients with vault prolapse. 15 Morciano et al, 16 in another recent study, concluded that continuous suturing is advantageous and better than multiple interrupted sutures for anterior and posterior vaginal mesh fixation during sacrocolpopexy.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of laparoscopic versus open sacrocolpopexy for vaginal vault prolapse – A study from a tertiary care center

et al. 2023

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Background: Post hysterectomy vault prolapse is a progressive herniation of the vaginal vault through the urogenital diaphragm and commonly leads to per vaginal bulge. Surgically, vault prolapse is corrected by sacrocolpopexy which can be done both as an open abdominal surgery and as a laparoscopic repair. Aims and Objectives: This study was performed to compare the therapeutic efficacies of laparoscopic and abdominal sacrocolpopexy. Materials and Methods: This study includes 50 cases of vault prolapsed who underwent hysterectomy previously, admitted in our institution and operated during January 2021–June 2022 for a period of 18 months with both open abdominal and laparoscopic sacrocolpopexy. We compared the basic characteristics, duration of surgery, post-operative stay, post-operative complications, and patient satisfaction between open and laparoscopic groups. Results: No significant difference was observed between the characteristics of the patients in the abdominal-approach group and the laparoscopic-approach group. The laparoscopic-approach group had a lower intraoperative estimated blood loss (187.8 vs. 90.3 mL, P<0.001) and a shorter operative time (148.0 vs. 115.3 min, P<0.001) than the abdominal-approach group. The complication rates of the two groups were not significantly different. Conclusion: Our Study is favorable for the use of laparoscopic approach over open abdominal surgery for treating cases of vault prolapse for sacrocolpopexy. The less invasive method leads to less blood loss and a shorter operative time than an open approach.

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“… 21 Also, in accordance with our findings, recent single Institutional prospective studies reported POP correction being not influenced by concomitant hysterectomy. 17 , 22 Moreover, a systematic review and meta-analysis in 2016 reported concomitant hysterectomy for POP repair as a risk factor for mesh erosion. 23 In this regard, Powell et al in their series reported a higher rate of erosions and mesh-related complications after RSCP, maybe secondary to a higher percentage of patients previously hysterectomized or undergoing concomitant hysterectomy.…”

Section: Discussionmentioning

confidence: 99%

Robot-assisted sacro(hystero)colpopexy with anterior and posterior mesh placement: impact on lower bowel tract function and clinical outcomes at mid-term follow-up

Marzi

Morselli

Maida

et al. 2022

Therapeutic Advances in Urology

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Background: Robotic sacrocolpopexy (RSCP) is an established option for the treatment of apical, anterior, and proximal posterior compartment pelvic organ prolapses (POP). However, there is lack of evidence investigating how lower bowel tract symptoms (LBTS) may change after RSCP. Methods: Data from consecutive patients treated with RSCP for stage 3 or higher POP from 2012 to 2019 at a single tertiary referral center with at least 1 year of follow-up were prospectively collected and retrospectively analyzed. RSCP was performed following a standardized technique which always employed both anterior and posterior hand-shaped meshes. Outcomes were collected at follow-up and analyzed. LBTS were evaluated through the Wexner questionnaire. Results: Overall, 114 women underwent RSCP. Eleven were excluded for missing data, whereas 12 had insufficient follow-up. Thus, 91 (79.8%) patients were included in this cohort. Median follow-up was 42 [interquartile range (IQR), 19–62] months. Mean age was 65 ± 10 years. In our series, RSCP was mainly performed for anterior and apical/medium stage 3 POP (in 95.6% of patients). Anatomic success rate of RSCP was 97.8%, with 89 patients with POP stage 0–1 at 12-month follow-up. Two patients (2.2%) experienced POP recurrence and were treated with redo-SCP. No patient experienced clinically significant posterior vaginal wall prolapse after RSCP. When analyzing LBTS, there was no significant change in postoperative total Wexner’s score as compared to the preoperative value ( p > 0.05). However, the manual assistance subscore was statistically significantly lower within the first-year follow-up ( p = 0.04), but it spontaneously improved during the follow-up ( p = 0.12). Conclusion: RSCP with simultaneous placement of both anterior and posterior mesh is safe and successful to treat high-stage POP in carefully selected patients. Of note, LBTS appear unaffected by posterior mesh placement, supporting its routine use to prevent posterior POP recurrence. Larger prospective studies are needed to confirm our results.

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Laparoscopic sacral hysteropexy versus laparoscopic sacral colpopexy plus supracervical hysterectomy in patients with pelvic organ prolapse

Cited by 27 publications

References 27 publications

Analysis on Effects of Laparoscopic Total Hysterectomy Combined with High Hysterosacral Ligament Suspension in the Treatment for Uterine Prolapse

Analysis on Effects of Laparoscopic Total Hysterectomy Combined with High Hysterosacral Ligament Suspension in the Treatment for Uterine Prolapse

Evaluation of laparoscopic versus open sacrocolpopexy for vaginal vault prolapse – A study from a tertiary care center

Robot-assisted sacro(hystero)colpopexy with anterior and posterior mesh placement: impact on lower bowel tract function and clinical outcomes at mid-term follow-up

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