Patient satisfaction after laparoscopic lateral suspension with mesh for pelvic organ prolapse: outcome report of a continuous series of 417 patients

Abstract

LLS is a safe technique with promising results in terms of a composite outcome, low complication rates and high long-term patient satisfaction. However, a randomized controlled trial is needed to establish the technique as an alternative to sacropexy in the treatment of POP in obese and high morbidity patients.

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

“…In studies regarding pectopexy, we found one (2.3%) relapse of apical prolapse after pectopexy reported by Noe after 21.8 months of follow‐up and none in the initial study by Banerjee . In the LLS technique group, objective cure rates at the 1‐year follow‐up were 91.6% for the anterior, 93.6% for the apical, and 85.3% for the posterior compartment …”

“…De novo constipation occurred mostly after sacropexy and was reported by 1.9%‐11.4% of patients with the highest rate (19.5%) in a study by Noe et al Boudy et al 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% to 8.4% the rates of de novo constipation were significantly lower for the LLSUP group (2.2%) as compared with the LLSHE group (4.3%, P = .008).…”

“…In younger patients, in addition to anatomical success, preservation of the uterus and unaffected sexual function are equally important . In a study by Veit‐Rubin, the percentage of sexually active women was higher at 1 year after LLS than before surgery (57.7% vs 44.8%) . Obese patients benefit from laparoscopic approaches, such as pectopexy, which is associated with reduced postoperative morbidity, better wound healing and improved surgical conditions, when access to the anterior longitudinal ligament is limited .…”

“…Dällenbach et al reported the longest follow‐up period for LLS (mean 82.3 months; range 28.2‐130.6) with mesh erosion in 3.8% of patients. In a study by Veit‐Rubin, the mesh exposure rate was 4.3% after mean 7.2 years; however, the surgical outcome evaluation was subjective, with a response rate of only 51.3%.…”

“…In LLS after entering the abdominal cavity, the polypropylene T‐shaped mesh is fixed to the dissected anterior and posterior vaginal walls. Next, retroperitoneal tunneling is performed and the mesh is pushed toward the round ligaments and cut off outside the abdominal cavity, above the skin …”