Outcomes of laparoscopic sacropexy in women over 70: A comparative study

Thubert, Thibault; Vinchant, Marie; Hermieu, J.-F.; Villefranque, Vincent; Deffieux, X.

doi:10.1016/j.ejogrb.2016.11.008

Cited by 18 publications

(17 citation statements)

References 27 publications

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“…Wound infection was the most common complication for abdominal sacrocolpopexy . Bowel injury occurred mostly during sacropexy: in 0.69%‐1.9% of patients after LS and in 3.4%‐3.7% after abdominal approach sacropexy …”

Section: Resultsmentioning

confidence: 99%

“…Bowel injury occurred mostly during sacropexy: in 0.69%‐1.9% of patients after LS and in 3.4%‐3.7% after abdominal approach sacropexy 2.8%, 0.8%, and 0.3%), pectopexy (1.7%), and abdominal sacropexy (1.4%).…”

Section: Resultsmentioning

confidence: 99%

“…Wound infection was the most common complication for abdominal sacrocolpopexy. 28 Bowel injury occurred mostly during sacropexy: in 0.69%-1.9% of patients after LS 30,34 and in 3.4%-3.7% after abdominal approach sacropexy. 29,35 Bladder lesions were reported in 12 studies during LS (15 patients), LUSLS (two patients), LLS (five patients).…”

Section: Complicationsmentioning

confidence: 99%

“…29,35 Bladder lesions were reported in 12 studies during LS (15 patients), LUSLS (two patients), LLS (five patients). 24,25,29,31,34,[36][37][38][39] Intraoperative hemorrhage was reported for LS (7.1%, 28 2.8%, 29 0.8%, 40 and 0.3% 41 ), pectopexy (1.7% 28 ), and abdominal sacropexy (1.4% 28 ). Ureteral injury occurred only once, during the LUSLS procedure.…”

Section: Complicationsmentioning

confidence: 99%

“…38,39 After LS reported only in one study by Anger et al 3 (7.9%). 33 De novo constipation occurred mostly after sacropexy and was reported by 1.9%-11.4% of patients 34,41 with the highest rate (19.5%) in a study by Noe et al 22 Boudy et al 34 dichotomized their subjects into those <70 and ≥70 years of age; constipation rates were 7.3% and 11.4%, respectively. Regarding LLS, constipation rates ranged from 5.5% 24 to 8.4%.…”

Section: Complicationsmentioning

confidence: 99%

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Comparison of laparoscopic techniques for apical organ prolapse repair – a systematic review of the literature

Szymczak

Grzybowska

Wydra

2019

Neurourology and Urodynamics

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Aims Apical defect is a pelvic organ prolapse disorder, with 5%‐15% prevalence. The aim of the study was to investigate methods of laparoscopic repair of apical defect and compare them with other techniques (open, vaginal, and robotic). Methods A systematic search of the literature was conducted in MEDLINE/PubMed and ClinicalTrials.gov databases using the following key words: apical prolapse and treatment procedures. The search was limited by using the humans filters. Only articles published in English between 2010 and 2018 were considered. Two independent authors reviewed the publications for inclusion on the basis of the following criteria: (a) use of laparoscopic techniques, and (b) apical support loss as indication for surgery. Results A total of 1002 papers were initially identified; 24 studies fulfilled the inclusion criteria. Four main laparoscopic procedures were found. The reported anatomical success rate (POP‐Q < II stage) was 77%‐100%, with patient satisfaction for pectopexy, laparoscopic sacropexy (LS), lateral ligament suspension and laparoscopic uterosacral ligament suspension (LUSLS) of 96.4%‐97.6%, 71.0%‐100%, 66.7%‐87.8%, and 95%‐95.5%, respectively. Major complications included hemorrhage, bladder, ureter, and/or bowel injuries were rare. Prolapse recurrences after LUSLS and LS were reported in 13.2% and 10.4% of patients, respectively; with reoperation rate for LS 2.2%‐12.8%. Conclusions Most studies reported anatomical and subjective outcomes, with follow‐up ranging from 1 month to >7 years. Success rates for laparoscopic and abdominal corrections of apical defect were similar; laparoscopy was superior in terms of perioperative blood loss, length of hospital stay, and recovery.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Complicationsmentioning

confidence: 99%

Section: Complicationsmentioning

confidence: 99%

Section: Complicationsmentioning

confidence: 99%

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Comparison of laparoscopic techniques for apical organ prolapse repair – a systematic review of the literature

Szymczak

Grzybowska

Wydra

2019

Neurourology and Urodynamics

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Effect of age in women undergoing laparoscopic sacrocolpopexy: A retrospective study

Malekzadeh,

Ramirez‐Caban,

Garcia‐Ruiz

et al. 2023

Intl J Gynecology & Obste

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ObjectiveTo determine whether elderly women (≥65 years) have an increased risk of complications and lower success when undergoing laparoscopic sacrocolpopexy (LSC) compared with younger women (<65 years).MethodsThis was a retrospective study of all LSC procedures performed from August 2014 to February 2021 by a single urogynecologic surgeon in an academic affiliated hospital system. Charts were identified through procedure codes. Patient demographics, clinical, surgical, and postoperative data were collected. The primary outcome of this study was to compare complications associated with LSC, including intraoperative and postoperative complications. Secondary outcomes included subjective, objective, and composite success.ResultsIn total, 312 participants met the criteria. The mean age of the group who were younger than 65 years was 55.7 years (±6.5) and of the group aged 65 years or older was 69.3 years (±3.5). Racial demographics revealed no differences between the two groups. Patients aged 65 years or older had a statistically significant lower body mass index (calculated as weight in kilograms divided by the square of height in meters), a higher rate of hypertension, smaller genital hiatus, and a larger anterior vaginal wall prolapse compared with the younger cohort. They also less often underwent a posterior repair. No statistically significant differences were found with regards to intraoperative and postoperative complications, including 30‐day re‐admission, between the two age groups. Both groups had high anatomic success rates, with no significant difference (<65 = 96.3%; ≥65 = 98.4%; P = 0.326). Those aged younger than 65 years compared with those aged 65 years or older had lower subjective success that was not significantly different (<65 = 62.8%; ≥65 = 71.0; P = 0.134). Composite success was noted to reach the threshold of a statistically significant difference in the group aged younger than 65 years compared with those aged 65 years or older (60.1% vs 71.0%; P = 0.0499).ConclusionIn this study, elderly patients did not have increased intraoperative and postoperative complications after undergoing LSC. Similar rates of anatomic and subjective success were also found with younger patients having a lower composite success. Proper candidates for LSC should not be excluded based upon age.

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