A prospective study of laparoscopic sacrocolpopexy for the management of pelvic organ prolapse

BJOG. 2009 Aug;116(9):1251-7. doi: 10.1111/j.1471-0528.2009.02116.x. Epub 2009 May 28.

Abstract

Objective: Assessment of the 2-year outcome of laparoscopic sacrocolpopexy.

Design: A prospective observational study of women undergoing laparoscopic sacrocolpopexy for prolapse.

Setting: A tertiary referral unit in the North West of England.

Population: A total of 22 women taking part in a prospective longitudinal study of prolapse who had a laparoscopic sacrocolpopexy between September 2002 and January 2005.

Methods: Women attended a research clinic where they completed validated quality-of-life questionnaires and were examined. Women were assessed preoperatively and postoperatively at 6 months, 1 year and 2 years.

Main outcome measures: Pelvic organ support assessed by Pelvic Organ Prolapse Quantification score. Assessment of the degree and impact of vaginal, urinary and bowel symptoms using validated quality-of-life questionnaires.

Results: At a mean follow up of 26.5 months, all 22 women had stage 0 vault support with 21 cured of prolapse symptoms. Stress urinary incontinence resolved in half of women without concomitant continence surgery. Bowel symptoms were uncommon, but of those reporting postoperative bowel symptoms, approximately one-third had no symptoms prior to surgery. No new onset dyspareunia was reported in those women sexually active at 2 years.

Conclusions: Laparoscopic sacrocolpopexy is a safe and effective treatment for vault prolapse, providing excellent vault support in the medium term. The outcome for anterior and posterior support is less predictable, and anatomical outcome correlated poorly with functional outcome.

MeSH terms

  • Fecal Incontinence / etiology
  • Female
  • Humans
  • Hysterectomy / adverse effects
  • Laparoscopy / methods*
  • Length of Stay
  • Middle Aged
  • Pelvic Floor / surgery*
  • Prolapse
  • Prospective Studies
  • Quality of Life
  • Sacrococcygeal Region / surgery*
  • Sexual Dysfunction, Physiological / etiology
  • Sexual Dysfunction, Physiological / surgery
  • Surgical Mesh
  • Surveys and Questionnaires
  • Urinary Incontinence, Stress / etiology
  • Urinary Incontinence, Stress / surgery
  • Uterine Prolapse / etiology
  • Uterine Prolapse / surgery*
  • Vagina / surgery*