Abstract
Our prospective study evaluates laparoscopic sacrocolpopexy for vaginal vault prolapse focusing on perioperative data, objective anatomical results using the pelvic organ prolapse quantification (POP-Q) system and postoperative quality of life using the Kings Health questionnaire. One hundred one patients completed the study. Fifty five had laparoscopic supracervical hysterectomy and sacrocolpopexy for uterine prolapse and 46 had laparoscopic sacrocolpopexy for post-hysterectomy prolapse. Median follow-up was 12 months. The subjective cure rate was 93% the objective cure rate (no prolapse in any compartment) according to the International Continence Society classification of prolapse was 98%. The main site of objective recurrence (6%) was the anterior compartment. No apical recurrences and no vaginal mesh erosion occurred. Postoperatively overall quality of life and sexual quality showed significant improvement with less than 1% de-novo dyspareunia. The procedure is recommended for experienced laparoscopic surgeons because of severe intraoperative complications like bladder or rectal injuries.
Similar content being viewed by others
References
Symmonds RE, Williams TJ, Lee RA, Webb MJ (1981) Posthysterectomy enterocele and vaginal vault prolapse. Am J Obstet Gynecol 140(8):852–859
Flynn BJ, Webster GD (2002) Surgical management of the apical vaginal defect. Curr Opin Urol 12(4):353–358
Benson JT, Lucente V, McClellan E (1996) Vaginal versus abdominal reconstructive surgery for the treatment of pelvic support defects: a prospective randomized study with long-term outcome evaluation. Am J Obstet Gynecol 175(6):1418–1421, discussion 1421–1422
Maher C, Baessler K, Glazener CM, Adams EJ, Hagen S (2007) Surgical management of pelvic organ prolapse in women: a short version Cochrane review. Neurourol Urodyn 27(1):3–12
Baessler K, Maher CF (2006) Mesh augmentation during pelvic-floor reconstructive surgery: risks and benefits. Curr Opin Obstet Gynecol 18(5):560–566
Nezhat CH, Nezhat F, Nezhat C (1994) Laparoscopic sacral colpopexy for vaginal vault prolapse. Obstet Gynecol 84(5):885–888
Bump RC, Mattiasson A, Bø K et al (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175(1):10–17
Kelleher CJ, Cardozo LD, Toozs-Hobson PM (1995) Quality of life and urinary incontinence. Curr Opin Obstet Gynecol 7(5):404–408
Schaer GN, Perucchini D, Munz E, Peschers U, Koechli OR, Delancey JO (1999) Sonographic evaluation of the bladder neck in continent and stress-incontinent women. Obstet Gynecol 93(3):412–416
Schaer GN, Koechli OR, Schuessler B, Haller U (1995) Improvement of perineal sonographic bladder neck imaging with ultrasound contrast medium. Obstet Gynecol 86(6):950–954
Gadonneix P, Ercoli A, Salet-Lizée D et al (2004) Laparoscopic sacrocolpopexy with two separate meshes along the anterior and posterior vaginal walls for multicompartment pelvic organ prolapse. J Am Assoc Gynecol Laparosc 11(1):29–35
Ross JW, Preston M (2005) Laparoscopic sacrocolpopexy for severe vaginal vault prolapse: five-year outcome. J Minim Invasive Gynecol 12(3):221–226
Maher CF, Qatawneh AM, Dwyer PL, Carey MP, Cornish A, Schluter PJ (2004) Abdominal sacral colpopexy or vaginal sacrospinous colpopexy for vaginal vault prolapse: a prospective randomized study. Am J Obstet Gynecol 190(1):20–26
Nygaard IE, McCreery R, Brubaker L, Connolly A, Cundiff G, Weber AM, Zyczynski H, Pelvic Floor Disorders Network (2004) Abdominal sacrocolpopexy: a comprehensive review. Obstet Gynecol 104(4):805–823
Cosson M, Bogaert E, Narducci F, Querleu D, Crépin G (2000) Laparoscopic sacral colpopexy: short-term results and complications in 83 patients. J Gynecol Obstet Biol Reprod (Paris) 29(8):746–750
Rozet F, Mandron E, Arroyo C et al (2005) Laparoscopic sacral colpopexy approach for genito-urinary prolapse: experience with 363 cases. Eur Urol 47(2):230–236
Antiphon P, Elard S, Benyoussef A et al (2004) Laparoscopic promontory sacral colpopexy: is the posterior, recto-vaginal, mesh mandatory? Eur Urol 45(5):655–661
Wattiez A, Canis M, Mage G, Pouly JL, Bruhat MA (2001) Promontofixation for the treatment of prolapse. Urol Clin North Am 28(1):151–157
Von Theobald P, Chéret A (2004) Laparoscopic sacrocolpopexy: results of a 100-patient series with 8 years follow-up. Gynecol Surg 1:31–36
Higgs PJ, Chua HL, Smith AR (2005) Long term review of laparoscopic sacrocolpopexy. BJOG 112(8):1134–1138
Seman EI, Cook JR, O’Shea RT (2003) Two-year experience with laparoscopic pelvic floor repair. J Am Assoc Gynecol Laparosc 10(1):38–45
Lefranc JP, Atallah D, Camatte S, Blondon J (2002) Longterm followup of posthysterectomy vaginal vault prolapse abdominal repair: a report of 85 cases. J Am Coll Surg. 95(3):352–358
Occelli B, Narducci F, Cosson M, Ego A, Decocq J, Querleu D, Crépin G (1999) Abdominal colposacroplexy for the treatment of vaginal vault prolapse with or without urinary stress incontinence. Ann Chir 53(5):367–377
Valaitis SR, Stanton SL (1994) Sacrocolpopexy: a retrospective study of a clinician’s experience. Br J Obstet Gynaecol 101(6):518–522
Snyder TE, Krantz KE (1991) Abdominal–retroperitoneal sacral colpopexy for the correction of vaginal prolapse. Obstet Gynecol 77(6):944–949
Fox SD, Stanton SL (2000) Vault prolapse and rectocele: assessment of repair using sacrocolpopexy with mesh interposition. Br J Obstet Gynecol 107(11):1371–1375
Hsiao KC, Latchamsetty K, Govier FE, Kozlowski P, Kobashi KC (2007) Comparison of laparoscopic and abdominal sacrocolpopexy for the treatment of vaginal vault prolapse. J Endourol. 2007 21(8):926–930
Paraiso MF, Walters MD, Rackley RR, Melek S, Hugney C (2005) Laparoscopic and abdominal sacral colpopexies: a comparative cohort study. Am J Obstet Gynecol 192(5):1752–1758
Conflicts of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Sarlos, D., Brandner, S., Kots, L. et al. Laparoscopic sacrocolpopexy for uterine and post-hysterectomy prolapse: anatomical results, quality of life and perioperative outcome—a prospective study with 101 cases. Int Urogynecol J 19, 1415–1422 (2008). https://doi.org/10.1007/s00192-008-0657-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00192-008-0657-0