Long-term anatomical and functional results of laparoscopic promontofixation for pelvic organ prolapse
Version of Record online: 26 AUG 2010
© 2010 THE AUTHORS. JOURNAL COMPILATION © 2010 BJU INTERNATIONAL
Volume 106, Issue 6, pages 861–866, September 2010
How to Cite
Sabbagh, R., Mandron, É., Piussan, J., Brychaert, P. E. and Tu, L. M. (2010), Long-term anatomical and functional results of laparoscopic promontofixation for pelvic organ prolapse. BJU International, 106: 861–866. doi: 10.1111/j.1464-410X.2009.09173.x
- Issue online: 26 AUG 2010
- Version of Record online: 26 AUG 2010
- Accepted for publication 22 October 2009
- laparoscopic promontofixation;
- long-term outcome;
- pelvic organ prolapse
Study Type – Therapy (case series) Level of Evidence 4
To assess the long-term anatomical and functional outcomes of laparoscopic promontofixation (LP) for pelvic organ prolapse (POP), and the long-term safety of LP, as POP is a common problem in women of all ages, with treatment including vaginal, abdominal, laparoscopic or robot-assisted surgical approaches.
PATIENTS AND METHODS
This was a retrospective study of the first consecutive 186 women who underwent LP for POP, with or without stress urinary incontinence (SUI), from January 1998 to December 2002 in one centre. Those patients with concurrent SUI had LP with a Burch colposuspension or tension-free vaginal tape (TVT). The recurrence rate of POP was evaluated by physical examination at follow-up visits and by the patients, using a postal, unvalidated self-applied questionnaire (SAQ). Patients’ urinary, sexual and digestive functions, overall satisfaction about surgery and quality of life, were evaluated with SAQ.
All 186 patients had LP, with concomitant Burch (25) or TVT (100) procedures. The median (interquartile range) follow-up was 60 (48–71) months. In all, 71% of the patients attended their follow-up visits and the success rate was 92.4%. Eight patients were re-operated because of recurrent POP. The SAQ response rate was 95%; 91.1% and 79.8% of responders were satisfied or very satisfied after their surgery, and with their quality of life, respectively; women were unsatisfied or very unsatisfied because of recurrence of POP (seven), urinary symptoms (five) or constipation (two). Patients complained of recurrent POP (10.8%), persistent or recurrent UI (27.3% of the women treated with Burch and 21.1% with TVT), and transient constipation (20%). Over half of the women (50.6%) were not sexually active and 5.4% developed dyspareunia. The long-term complication rate was 6%; there were five vaginal mesh erosions.
POP treated with LP offers excellent long-term results with low recurrence and morbidity rates, and a good quality of life.