Laparoscopic uterosacral ligament suspension: a comprehensive, systematic literature review

Campagna, Giuseppe; Panico, Giovanni; Lombisani, Andrea; Vacca, Lorenzo; Caramazza, Daniela; Scambia, Giovanni; Ercoli, Alfredo

doi:10.1016/j.ejogrb.2022.08.006

Cited by 9 publications

(4 citation statements)

References 33 publications

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“…A comprehensive review of existing literature underscores the safety and effectiveness of laparoscopic uterosacral ligament suspension as an approach for vaginal apex resuspension in women with POP. 12 However, the standalone application of USLS lacks the robustness and longevity exhibited by LSC. A retrospective cohort study encompassing 654 patients over a decade revealed that total vaginal hysterectomy combined with USLS was linked to a higher recurrence rate and shorter time to prolapse recurrence when contrasted with laparoscopic supracervical hysterectomy paired with mesh sacrocervicopexy.…”

Section: Discussionmentioning

confidence: 99%

“…Uterosacral ligament suspension is a common technique employed in the surgical management of apical prolapse with native tissue. A comprehensive review of existing literature underscores the safety and effectiveness of laparoscopic uterosacral ligament suspension as an approach for vaginal apex resuspension in women with POP 12 . However, the standalone application of USLS lacks the robustness and longevity exhibited by LSC.…”

Section: Discussionmentioning

confidence: 99%

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Clinical Efficacy of Modified Nonmesh Sacral Colpopexy for Pelvic Organ Prolapse

Zhao,

Liu,

Cui

et al. 2024

UROGC

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Importance As an increasing number of mesh-related complications have been reported, the availability of nonmesh alternatives becomes crucial for situations where mesh is not desired or unavailable. A new modified procedure of nonmesh laparoscopic sacral colpopexy (LSC) was performed in our department, which used a nonabsorbable polyester suture (Ethibond) combined with uterosacral ligament suspension. Objective The aim of this study was to evaluate the clinical efficacy of the modified procedure in comparison with traditional LSC in patients with pelvic organ prolapse. Methods This retrospective study assessed the treatment outcomes of 60 patients who were underwent LSC with or without mesh from January 2017 to April 2019. Patients were divided into 2 groups based on the presence or absence of mesh during the operation: mesh group (n = 34) and nonmesh group (n = 26). General data, perioperative indexes, postoperative complications, and recurrence rates were comparatively analyzed between 2 groups. Results In perioperative indexes, the nonmesh group exhibited shorter operation time (P < 0.001) and less intraoperative blood loss compared with the mesh group (P = 0.004). There was no significant difference in postoperative indwelling urinary catheter duration (P = 0.425) and hospitalization time (P = 0.827) between the 2 groups. In postoperative complications, the incidence of postoperative complications showed no significant difference between the 2 groups (P > 0.05). No occurrences of mesh exposure and erosion were observed in the mesh group during at least a 2-year follow-up period. In postoperative recurrence, none of the patients in either group experienced prolapse recurrence. Conclusions In comparison with the traditional LSC with mesh, the modified laparoscopic nonmesh sacral colpopexy presents advantages of reduced surgical trauma, less pain, and lower cost. However, a long-term and large sample study is required for evaluating the surgery’s long-term efficacy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clinical Efficacy of Modified Nonmesh Sacral Colpopexy for Pelvic Organ Prolapse

Zhao,

Liu,

Cui

et al. 2024

UROGC

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“…Laparoscopic approach to uterosacral ligament suspension (L-USLS) is now frequently adopted to improve visualization and decrease the rate of injury to contiguous structures such as the ureters, vessels, rectum, and sacral nerves. It is suitable for the treatment of younger women with uterine descent that, eventually, allows the preservation of the uterus ( 7 , 8 ). The aim of this study is to analyze perioperative outcomes, in terms of complications and risk of recurrence and reoperation, of laparoscopic USLS procedure.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic uterosacral ligament suspension: a systematic review and meta-analysis of safety and durability

Ronsini¹,

Pasanisi²,

Cianci³

et al. 2023

Front. Surg.

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IntroductionPelvic organ prolapse (POP) is a widespread condition affecting from 40% to 60% of women. Reconstructive vaginal surgeries are the most commonly performed procedures to treat POP. Among those, uterosacral ligament suspension (USLS), which is usually performed transvaginally, preserves pelvic statics and dynamics and appears to be an effective method. Laparoscopic USLS is a valid alternative to vaginal approach, and the aim of our review is to confirm its safety and feasibility and to compare clinical outcomes among the procedures.Materials and methodsFollowing the recommendations in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, we systematically searched the PubMed and Scopus databases in December 2022. We made no restriction on the publication year nor on the country. Data about POP-Q recurrence rate (RR), intraoperative and postoperative complications (graded according to Clavien–Dindo classification), readmission rate, and reoperation rate were collected and analyzed. We used comparative studies for meta-analysis.ResultsA total of nine studies fulfilled inclusion criteria: two articles were non-comparative retrospective observational studies, three more articles were comparative studies where laparoscopic USLS was confronted with other surgical techniques (only data of laparoscopic USLS were analyzed), and four were comparative retrospective cohort studies between laparoscopic and vaginal USLS procedures. The comparative studies were enrolled in meta-analysis. Patients were analyzed concerning perioperative risks and the risk of recurrence. The meta-analysis highlighted that there was no clear inferiority of one technique over the other.DiscussionLaparoscopic USLS is a technique with a low complication rate and low recurrence rate. Indeed, laparoscopic procedure allows better identification of anatomical landmarks and access to retroperitoneum. Moreover, efficacy over time and durability of Laparoscopic (LPS) USLS was also observed. However, these data should be weighed in light of the length of follow-up, which was in a very short range. Further, focused and prospective studies will be necessary to confirm this finding.

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“…Одним из методов коррекции апикального пролапса является суспензия крестцово-маточных связок, при которой эти связки фиксируются к своду влагалища. Данная процедура может выполняться как лапароскопическим, так и влагалищным доступом [36]. Систематический обзор 2021 г. показал, что анатомические и субъективные показатели успеха после лапароскопической суспензии крестцовоматочных связок достигали 79-100 % и 76,2-100 % соответственно.…”

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Modern methods of surgical treatment of pelvic organ prolapse

Boldyreva,

Tskhay,

Polstyanoy

et al. 2023

jour

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Genital prolapse is a relevant healthcare issue due to the increase in life expectancy and the need to improve the quality of life for patients. This article provides a review of literature on surgical treatment of genital prolapse, including the history of the evolution of correction methods. The use of mesh implants for correcting genital prolapse is separately described, as well as the complications associated with these surgeries.

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Laparoscopic uterosacral ligament suspension: a comprehensive, systematic literature review

Cited by 9 publications

References 33 publications

Clinical Efficacy of Modified Nonmesh Sacral Colpopexy for Pelvic Organ Prolapse

Clinical Efficacy of Modified Nonmesh Sacral Colpopexy for Pelvic Organ Prolapse

Laparoscopic uterosacral ligament suspension: a systematic review and meta-analysis of safety and durability

Modern methods of surgical treatment of pelvic organ prolapse

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