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Women's Health & Gynecology

JWHG

Aabstract

Research Article

Laparoscopic Sacro(Hystero)colpopexy: Twenty Years after

Elodie Massou, Angelique Cheret, Naama Marcus-Braun and Peter Von Theobald

Correspondence Address :

Peter von Theobald
Service de gynecologie-obstetrique
CHU Reunion Nord, Hopital Felix Guyon, 97400 Saint-Denis
France
Email: peter.vontheobald@chu-reunion.fr

Received on: March 7, 2016, Accepted on: March 30, 2016, Published on: April 7, 2016

Citation: Elodie Massou, Angelique Cheret, Naama Marcus-Braun, Peter Von Theobald (2016). Laparoscopic Sacro(hystero)colpopexy: Twenty Years after

Copyright: 2016 Peter Von Theobald, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

  • Abstract

Abstract
Objective: Assessment of long term outcome following laparoscopic sacro(hystero)colpopexy (LSCP). 
Design: Combine retrospective and prospective monocentric study using standardized quality of life questionnaires and pelvic organ prolapse quantification system (POP-Q).
Setting: A tertiary gynecology unit in the North West of France.
Population: One hundred and four consecutive women who had laparoscopic LSCP at the University Hospital of Caen between 1993 and 2002.
Methods: Women were examined in gynecology clinic and completed questionnaires or answered postal questionnaires if unable to attend the unit. 
Main outcome measures: POP recurrence rate assessed by POP-Q score. Assessment of functional outcome using validated questionnaires (PDFI-20, PFIQ-7). Risk factors for recurrence. 
Results: Eighty women were contacted after a median of 13 years. Fifty-one women were examined and a further 29 women completed questionnaires only. Twenty women (25%) had a repeat surgery for recurrence, mainly cystocele after 6 years average. Eleven women (21.5%) had recurrent prolapse at examination. Multivariate analysis identifies large cystocele as a significant risk factor for recurrence (p=0.049). Long term complication rate is 11.3% including 5 vaginal erosions occurring after 3 to 12 years (6.25%). Quality of life questionnaires showed improvement in bladder and pelvic symptoms but impairment in bowel symptoms, mainly constipation, without impact on QoL scores: 92.5% said their quality of life was improved after laparoscopic LSCP after 13 years.
Conclusions: LSCP is an effective treatment of pelvic organ prolapse. Recurrence and erosion happen later than described in literature. Quality of life is improved after 13 years with a 25% reoperation rate.
Keywords: Sacrocolpopexy, Laparoscopy, Pelvic organ prolapse

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