Laparoscopic sacrocolpopexy with bone anchor fixation: short-term anatomic and functional results

Abstract

Introduction and hypothesisThe aim of this study was to evaluate short-term anatomic and functional outcomes and safety of laparoscopic sacrocolpopexy with bone anchor fixation.MethodsA prospective cohort study of women undergoing laparoscopic sacrocolpopexy between 2004 and 2009. Anatomic outcome was assessed using the pelvic organ prolapse quantification score (POP-Q). Functional outcomes were assessed using the Urogenital Distress Inventory, Defecatory Distress Inventory, and the Incontinence Impact Questionnaire preoperatively and at 6 months postoperatively. The Wilcoxon signed rank test was used to test differences between related samples.ResultsForty-nine women underwent laparoscopic sacrocolpopexy. The objective success rate in the apical compartment was 98%, subjective success rate was 79%. One mesh exposure (2%) was found. One conversion was necessary due to injury to the ileum.ConclusionsLaparoscopic sacrocolpopexy with bone anchor fixation is a safe and efficacious treatment for apical compartment prolapse. It provides excellent apical support and good functional outcome 6 months postoperatively.

Satisfaction, quality of life and lumbar pain following laparoscopic sacrocolpopexy: suture vs. tackers

“…Various prosthesis fixation techniques can be used: nonabsorbable tackers, nonabsorbable sutures such as Mersuture 1 , and Arthrex AR-1925S titanium bone anchor fixations [2]. All of these means of fixation have been analyzed in non-comparative studies [3,4]. The incidence of de novo dorsolumbar pain following LS remains unclear, but some authors have hypothesized that the use of tackers for the fixation on the anterior vertebral ligament may be associated with an increase in complication rates [5].…”

Sequential urodynamic assessment before and after laparoscopic sacrocolpopexy

“…The high overall anatomic failure rates for the anterior and posterior compartment at six months might be explained by the fact that we only performed the apical compartment repair in order to decrease the risk for mesh exposure and to avoid irritable bladder symptoms. However, the effects of surgery on symptoms and health‐related quality of life scores also demonstrated a statistically significant improvement in items involving the anterior and posterior compartment . Although occasionally de novo detrusor activity and de novo stress urinary incontinence may occur, we conclude that the overall absence of adverse urodynamic findings following surgery does not support simultaneous routine prophylactic suspension procedures.…”

“…Pre-and postoperative POP-Q exams and peri-operative data have been published earlier (11). Summarized, median operating time was 120 min (range 60-240) and median blood loss 50 mL (range 10-100).…”

“…To these were added four women with a POP‐Q stage II uterine prolapse only. Short‐term and functional results of this patient selection, focusing on prolapse of the middle compartment, have been reported . Pre‐ and postoperative investigations included: (i) a POP‐Q assessment , (ii) questionnaires [Urogenital Distress Inventory, Incontinence Impact Questionnaire and the Defecatory Distress Inventory ], (iii) a bladder diary and conventional urodynamic investigation and (iv) dynamic MRI.…”

Laparoscopic sacral colpopexy versus total vaginal mesh for vault prolapse; comparison of cohorts

“…1. All women undergoing LSC and 20 out of 52 (38 %) undergoing TVM have previously been described [9,24]. Baseline characteristics are shown in Table 1.…”