Laparoscopic cervicopexy in uterine prolapse, a prospective study
Keywords:Intraoperative complications, Laparoscopic cervicopexy, Pelvic organ prolapsed, Postoperative complications, Synthetic mesh, Uterine prolapsed
Background: Pelvic organ prolapse is a common condition and a major cause of gynecological surgery. The lifetime risk of having an operation for prolapse may be 11%. Uterine conserving surgeries using synthetic mesh, especially in younger age group can restore normal anatomy relieving their pelvic symptoms. To evaluate the safety, intra operative and postoperative complications and efficacy of the laparoscopic cervicopexy.
Methods: This Prospective observational study was carried out on women aged below 45 years attending gynaecology outpatient department with uterine prolapse at MES Medical College, Perinthalmanna between January 1st and December 31st, 2015. 39 women underwent laparoscopic cervicopexy and follow up assessments was done among them at 2 weeks, 3 months and 6 months.
Results: The mean operative time was 27.6 minutes and blood loss was 0.4 gm/dl. No intraoperative and postoperative complications occurred. Short duration of hospital stay with mean of 1.4 days. 7.7% patients and 5.5% had mersilene tape reaction at 3 months and 6 months. The POP Q score C was significantly away from hymen at 2 weeks,3 months and 6 months (+4.4 - -4.3). 7.7% and 2.6% had recurrence at 3 month and 6 months. 5.1% underwent vaginal hysterectomy to get relieved from symptom.
Conclusion: Laparoscopic cervicopexy is an effective option for women with pelvic organ prolapse who desire uterine preservation.
Williams gynecology second edition. Chapter 24:633-658.
Wu MP. Laparoscopic uterine suspension for the treatment of uterovaginal prolapse. Inter J Gynecol Obstetr. 1997 Dec;59(3):259-60.
Uccella S, Ghezzi F, Bergamini V, Serati M, Cromi A, Franchi M, et al. Laparoscopic uterosacral ligaments plication for the treatment of uterine prolapse. Archives of gynecology and obstetrics. 2007 Sep 1;276(3):225-9.
Cutner A, Kearney R, Vashisht A. Laparoscopic uterine sling suspension: a new technique of uterine suspension in women desiring surgical management of uterine prolapse with uterine conservation. BJOG: Int J Obstetr Gynaecol. 2007 Sep ;114(9):1159-62.
Maher CF, Carey MP, Murray CJ. Laparoscopic suture hysteropexy for uterineprolapse. Obstetr Gynecol. 2001;97:1010-4.
Grimminck K, Mourik SL, Tjin-Asjoe F, Martens J, Aktas M. Long-term follow-up and quality of life after robot assisted sacrohysteropexy. European J Obstet Gynecol Reprod Biol. 2016 Nov 1;206:27-31.
Forde J, Chughtai B, Stone B, Hsu WC, Mao J, Te A. Role of uterine preserving surgery in mesh based pelvic organ prolapsed repair. J urol. 2016:195: e105.
Liu CK, Tsai CP, Chou MM, Shen PS, Chen GD, Hung YC, et al. A comparative study of laparoscopic sacrocolpopexy and total vaginal mesh procedure using lightweight polypropylene meshes for prolapse repair. Taiwanese J Obstetr Gynecol. 2014 Dec 1;53(4):552-8.
Elliott DS, Frank I, Dimarco DS, Chow GK. Robotically assisted laparoscopy: sacrocolpopexy for the treatment of uterine prolapsed. Am J Surg. 2004 Oct;188(4A Suppl):52S-56S.
Swan K, Advincula AP. Advances in urogynaecological robotic surgery. BJU International. 2011 Sep;108(6 Pt 2):1024-7.
Lin LL, Ho MH, Haessler AL, Betson LH, Alinsod RM, Liu CY, et al. A review of laparoscopic uterine suspension procedures for uterine preservation. Current Opinion in Obstetr Gynecol. 2005 Oct 1;17(5):541-6.
Morgan DM, Rogers MA, Huebner M, Wei JT, DeLancey JO. Heterogeneity in anatomic outcome of sacrospinous ligament fixation for prolapse: a systematic review. Obstetr Gynecol. 2007 Jun 1;109(6):1424-33.
Dwyer PL, O'Reilly BA. Transvaginal repair of anterior and posterior compartment prolapse with Atrium polypropylene mesh. BJOG: An International J Obstetr Gynaecol. 2004 Aug;111(8):831-6.
Davila GW, Jijon A. Managing vaginal mesh exposure/erosions. Current Opinion in Obstetr Gynecol. 2012 Oct 1;24(5):343-8.
Rosenblatt PL, Chelmow D, Ferzandi TR. Laparoscopic sacrocervicopexy for the treatment of uterine prolapse: a retrospective case series report. J minimally invasive gynecol. 2008 May 1;15(3):268-72.
Asgharnia M, Faraji R, Salamat F, Ashrafkhani B, Heirati SF, Naimian S. Perinatal outcomes of pregnancies with borderline versus normal amniotic fluid index. Iranian journal of reproductive medicine. 2013 Sep;11(9):705.
Fatton B, Amblard J, Debodinance P, Cosson M, Jacquetin B. Transvaginal repair of genital prolapse: preliminary results of a new tension-free vaginal mesh (Prolift™ technique)-a case series multicentric study. Int Urogynecol J. 2007 Jul 1;18(7):743-52.
Rimailho J, Talbot C, Bernard JD, Hoff J, Becue J. L'hystéropexie antérolatéralepar voie abdominale. Résultats et indications. A propos d'une série de quatrevingt- douze patients. InAnnales de chirurgie 1993;47(3):244-9.