Objective: Use of vaginal meshes for treatment of pelvic organ prolapse (POP) remains controversial. A trend toward abdominal approaches and the development of new meshes has been noted. We compared the 1-year results of two different approaches using new lightweight meshes.
Materials And Methods: Sixty-nine (95.8%) of 72 women with POP Stage ≥ 2, who underwent laparoscopic sacrocolpopexy (LSC) (n = 39) or a total vaginal mesh (TVM) procedure (n = 30) using lightweight polypropylene meshes, were studied. Baseline and follow-up assessments included a pelvic examination and a composite condition-specific questionnaire. A detailed comparison of 1-year outcomes was made. Data were analyzed using appropriate statistical methods.
Results: Compared to the TVM group, the LSC group was characterized by a younger age (53.7 years vs. 64.1 years, p < 0.001) and a longer operating time (264 minutes vs. 177.6 minutes, p < 0.001). Objective anatomic success (POP Stage ≤ 1) rates were similar between groups after statistical adjustment, i.e., 84.6% (33/39) and 86.7% (26/30) after LSC and TVM (p = 0.94), respectively. However, the dominant recurrence sites were different with anterior (n = 6) most frequent after LSC and apical (n = 4) most frequent after TVM. Reoperations were needed for the four (13.3%) apical recurrences in the TVM group. No serious complications were noted. We found "cystocele as the dominant prolapse" (p = 0.016; odds ratio = 6.94) and "suspension of prolapsed (POP Stage ≥ 2) uterus" (p = 0.025; odds ratio = 7.00) significantly affected recurrence after LSC and TVM, respectively.
Conclusion: POP repair by LSC or TVM using the new lightweight polypropylene meshes seems to be safe and has comparable outcomes, but limitations may vary.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.tjog.2014.07.006 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Minimally Invasive Total Versus Supracervical Hysterectomy With Sacrocolpopexy.
Urogynecology (Phila)
October 2024
Atrium Wake Forest Baptist Health, Winston-Salem, NC.
Article Synopsis
- The study compares total laparoscopic hysterectomy (TLH) and laparoscopic supracervical hysterectomy (LSCH) during minimally invasive sacrocolpopexy for treating uterovaginal prolapse.
- Results showed no significant difference in overall recurrence of prolapse between the two methods, but TLH had lower odds of recurrence in multivariable analysis.
- TLH had a higher proportion of mesh exposures with lightweight mesh, but this finding wasn't significant after adjusting for other factors.
Robot-Assisted Laparoscopic Sacrohysteropexy with Autologous Fascia Lata.
Int Urogynecol J
December 2024
Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, 3168, Australia.
Introduction And Hypothesis: Autologous fascia lata has been increasingly utilised in pelvic floor reconstructive surgeries such as sacrocolpopexy and sacrohysteropexy. This case highlights sacrohysteropexy with autologous fascia lata as a promising option for women with advanced uterovaginal prolapse who wish to preserve their uterus and avoid synthetic mesh.
Methods: We report the case of a 65-year-old woman with stage 3 pelvic organ prolapse following one forceps and one spontaneous vaginal delivery.
Comparison of sexual function between laparoscopic lateral suspension and laparoscopic sacrocervicopexy with the use of the PISQ-IR questionnaire.
Front Med (Lausanne)
December 2024
Hôpitaux Universitaires de Genève (HUG), Geneva, Switzerland.
Introduction And Hypothesis: We aimed to analyze the quality of sexual life of patients with apical vaginal wall prolapse who had undergone laparoscopic lateral suspension (LLS) and laparoscopic sacrocolpopexy (LSC).
Methods: We performed a secondary analysis of sexual outcomes of a previous randomized control trial comparing LLS and LSC in 89 women with symptomatic POP stage ≥ II. We evaluated sexually active (SA) and non-sexually active women (NSA) using the Pelvic Organ Prolapse/Incontinence Sexual Questionnaire-IUGA-Revised (PISQ-IR).
Background: The advantages and disadvantages of Robotic Laparoscopic Surgery (RLS) compared to other minimally invasive surgical approaches are debated in the literature.
Objective: To evaluate the learning curves (LC) and their assessment methods for Robotic Laparoscopic Surgery (RLS) and Laparoscopic Surgery (LPS) in gynaecologic procedures.
Materials And Methods: A systematic review of the literature was performed including the English language observational or interventional studies reporting the absolute number of procedures needed to achieve competency in RLS and LPS gynaecologic procedures, along with an objective and reproducible LC assessment method.
Composite Failure Associated With Sacrohysteropexy and Sacrocolpopexy With Supracervical Hysterectomy for Advanced Pelvic Organ Prolapse.
Neurourol Urodyn
December 2024
Department of Orthopedics, Hokusuikai Kinen Hospital, Ibaraki, Japan.
Objectives: Failures and complications associated with treatments comprising laparoscopic sacrohysteropexy (SHP) for advanced pelvic organ prolapse (POP) are unclear. We compared failure rates associated with SHP and laparoscopic supracervical hysterectomy (SCH)/sacrocolpopexy (SCP) for advanced POP to determine whether they differed.
Methods: Clinical data of patients who underwent SHP (n = 52) and SCH/SCP (n = 209) were retrospectively examined.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!