Feasibility of laparoscopic sacrocolpopexy in pelvic organ prolapse: a single centre prospective observational study
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20251569Keywords:
Laparoscopic sacrocolpopexy, Pelvic organ prolapse, Mesh repair, Vault prolapseAbstract
Background: Pelvic organ prolapse (POP) is a prevalent gynaecological condition that significantly impacts women's quality of life across all age groups. Surgical treatment is often necessary, laparoscopic sacrocolpopexy (LSC), offers a minimally invasive option with promising results. This study done in a tertiary care laparoscopic and robotic centre (GEM Hospital, Coimbatore) aims to explore the advantages of laparoscopic sacrocolpopexy.
Methods: This is a prospective study conducted over a period of 5 years. The participants are women who attended the gynecology clinic and were detected to have prolapse symptoms with a grade 2 or more descent of anterior wall, apex or posterior wall of vagina. Participants were followed until the 6th month of post-operative period.
Results: A total of 54 women were included in the study, most of them being multiparous. 30 out of the 54 women were obese, that signifies the association of obesity with pelvic organ prolapse. 54 patients underwent laparoscopic sacrocolpopexy, of which 7 patients underwent concomitant total laparoscopic hysterectomy (TLH) with sacrocolpopexy. 4 patients underwent laparoscopic sacrocolpopexy along with paravaginal cystocoele repair. The average time calculated was 182 minutes. All the patients reviewed at 3 months and 6 months post-op, had no symptoms of descent and on examination, 2 patients had Bp point at the level of -1.
Conclusions: Laparoscopic sacrocolpopexy offers comparable objective and subjective cure rates to open surgery and is a safe and effective treatment for vaginal vault prolapse, providing long-term anatomical restoration and cure.
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References
Pelvic Organ Prolapse: ACOG Practice Bulletin, Number 214. Obstet Gynecol. 2019;134(5):e126-42. DOI: https://doi.org/10.1097/AOG.0000000000003519
Parulekar MS, Parulekar SV. Analysis of epidemiological factors for pelvic floor defects in Indian women. Int J Reprod Contracept Obstet Gynecol. 2020;9(6):2492-7. DOI: https://doi.org/10.18203/2320-1770.ijrcog20202335
Virkud A. Conservative Operations in Genital Prolapse. J Obstet Gynaecol India. 2016;66(3):144-8. DOI: https://doi.org/10.1007/s13224-016-0909-8
Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL. Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol. 1997;89(4):501-6. DOI: https://doi.org/10.1016/S0029-7844(97)00058-6
NICE. Urinary incontinence and pelvic organ prolapse in women: management. 2019. Available at: https://www.nice.org.uk/guidance/ng123. Accessed on 29 March 2025. DOI: https://doi.org/10.1111/bju.14763
DeLancey JO. Anatomic aspects of vaginal eversion after hysterectomy. Am J Obstet Gynecol. 1992;166(6 Pt 1):1717-24. DOI: https://doi.org/10.1016/0002-9378(92)91562-O
Shull BL, Bachofen C, Coates KW, Kuehl TJ. A transvaginal approach to repair of apical and other associated sites of pelvic organ prolapse with uterosacral ligaments. Am J Obstet Gynecol. 2000;183(6):1365-73. DOI: https://doi.org/10.1067/mob.2000.110910
Addison WA, Livengood CH, Sutton GP, Parker RT. Abdominal sacral colpopexy with Mersilene mesh in the retroperitoneal position in the management of posthysterectomy vaginal vault prolapse and enterocele. Am J Obstet Gynecol. 1985;153(2):140-6. DOI: https://doi.org/10.1016/0002-9378(85)90098-5
Nezhat CH, Nezhat F, Nezhat C. Laparoscopic sacral colpopexy for vaginal vault prolapse. Obstet Gynecol. 1994;84(5):885-8.
Giri A, Hartmann KE, Hellwege JN, Velez Edwards DR, Edwards TL. Obesity and pelvic organ prolapse: a systematic review and meta-analysis of observational studies. Am J Obstet Gynecol. 2017;217(1):11-26. DOI: https://doi.org/10.1016/j.ajog.2017.01.039
Wen Q, Zhao Z, Wen J, Yang Y, Wang L, Wu J, et al. Impact of obesity on operative complications and outcome after sacrocolpopexy: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2021;258:309-16. DOI: https://doi.org/10.1016/j.ejogrb.2021.01.032
Higgs PJ, Chua HL, Smith ARB. Long term review of laparoscopic sacrocolpopexy. BJOG Int J Obstet Gynaecol. 2005;112(8):1134-8. DOI: https://doi.org/10.1111/j.1471-0528.2005.00646.x
North C, Ali-Ross N, Smith A, Reid F. A prospective study of laparoscopic sacrocolpopexy for the management of pelvic organ prolapse. BJOG Int J Obstet Gynaecol. 2009;116(9):1251-7. DOI: https://doi.org/10.1111/j.1471-0528.2009.02116.x
Granese R, Candiani M, Perino A, Romano F, Cucinella G. Laparoscopic sacrocolpopexy in the treatment of vaginal vault prolapse: 8 years experience. Eur J Obstet Gynecol Reprod Biol. 2009;146(2):227-31. DOI: https://doi.org/10.1016/j.ejogrb.2009.06.013
Sabbagh R, Mandron E, Piussan J, Brychaert PE, Tu LM. Long-term anatomical and functional results of laparoscopic promontofixation for pelvic organ prolapse. BJU Int. 2010;106(6):861-6. DOI: https://doi.org/10.1111/j.1464-410X.2009.09173.x
Price N, Slack A, Jackson SR. Laparoscopic sacrocolpopexy: an observational study of functional and anatomical outcomes. Int Urogynecol J. 2011;22(1):77-82. DOI: https://doi.org/10.1007/s00192-010-1241-y
Ganatra AM, Rozet F, Sanchez-Salas R, Barret E, Galiano M, Cathelineau X, et al. The current status of laparoscopic sacrocolpopexy: a review. Eur Urol. 2009;55(5):1089-103. DOI: https://doi.org/10.1016/j.eururo.2009.01.048
Manodoro S, Werbrouck E, Veldman J, Haest K, Corona R, Claerhout F, et al. Laparoscopic Sacrocolpopexy. Facts Views Vis ObGyn. 2011;3(3):151-8.
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