A novel technique for the management of advanced uterine/vault prolapse: extraperitoneal sacrocolpopexy.

Introduction And Hypothesis: Abdominal sacrocolpopexy is the gold standard for advanced uterovaginal/cuff prolapse repair; however, early and late bowel complications are of concern. We report our experience with extraperitoneal sacrocolpopexy (ESCP).

Methods: Twenty-three patients who underwent ESCP between 2007 and 2010 were analyzed in this retrospective cohort study. Preoperative assessment included Pelvic Floor Distress Inventory (PFDI-20) and Pelvic Floor Impact (PFIQ-7) questionnaires, and pelvic examination according to Pelvic Organ Prolapse Quantification (POP-Q) system. Pre-operative findings were compared with postoperative values at the last follow-up using the Wilcoxon sign test.

Results: Mean operation time was 86 ± 20 min. Twenty patients were discharged within 24 h. With a mean follow-up of 20 months, objective and subjective cure rates were 91.3% and 86.9%, respectively. No postoperative complications were evident with significant improvement in POP-Q, PFDI-20, and PFIQ-7 scores.

Conclusions: ESCP is a safe and effective sacrocolpopexy procedure that can potentially eliminate the risk of gastrointestinal complications.