Patient satisfaction after laparoscopic lateral suspension with mesh for pelvic organ prolapse: outcome report of a continuous series of 417 ... View Full Text


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Article Info

DATE

2017-04-17

AUTHORS

Nikolaus Veit-Rubin, Jean-Bernard Dubuisson, Angèle Gayet-Ageron, Sören Lange, Isabelle Eperon, Jean Dubuisson

ABSTRACT

Introduction and hypothesisSacropexy is considered the gold standard for the treatment of pelvic organ prolapse (POP) although dissection of the promontory may be challenging, particularly in obese women. Laparoscopic lateral suspension with mesh (LLS) could be an alternative.MethodsLLS provides lateral attachment by fibrosis of a vesicovaginal mesh. Clinical evaluation was performed at 1 year using the simplified POP quantification system (POP-Q). Primary outcomes were objective and subjective cure at 1 year. After a mean of 7.2 years the rates of reoperation and complications were assessed as secondary outcomes. Patient satisfaction was evaluated by telephone interview using a ten-point-scale and the PGI-I scale. Factors predicting satisfaction were determined by logistic regression analysis.ResultsA total of 417 patients were treated between 2003 and 2011. At 1 year 78.4% of patients were asymptomatic and anatomic success rates were 91.6% for the anterior compartment, 93.6% for the apical compartment and 85.3% for the posterior compartment. The complication rate of Clavien-Dindo grade III or higher was 2.2%. The mesh exposure rate was 4.3% and the reoperation rate was 7.3%. Of the 417 patients, 214 participated in the telephone interview. Over 85% rated their situation as improved and satisfaction was associated with the absence of concomitant hysterectomy.ConclusionsLLS is a safe technique with promising results in terms of a composite outcome, low complication rates and high long-term patient satisfaction. However, a randomized controlled trial is needed to establish the technique as an alternative to sacropexy in the treatment of POP in obese and high morbidity patients. More... »

PAGES

1685-1693

References to SciGraph publications

  • 2005-11-30. Laparoscopic sacral suture hysteropexy for uterine prolapse in INTERNATIONAL UROGYNECOLOGY JOURNAL
  • 2015-10-17. Uterus-preserving laparoscopic lateral suspension with mesh for pelvic organ prolapse: a patient-centred outcome report and video of a continuous series of 245 patients in INTERNATIONAL UROGYNECOLOGY JOURNAL
  • 2006-04. Clinical implications of the biology of grafts: conclusions of the 2005 IUGA Grafts Roundtable in INTERNATIONAL UROGYNECOLOGY JOURNAL
  • 2009-12-15. Validation of the Patient Global Impression of Improvement (PGI-I) for urogenital prolapse in INTERNATIONAL UROGYNECOLOGY JOURNAL
  • 2013-10-19. Apical prolapse in INTERNATIONAL UROGYNECOLOGY JOURNAL
  • 2013-11-20. What do we know about titanized polypropylene meshes? An evidence-based review of the literature in HERNIA
  • 2006-04-06. Validation of a simplified technique for using the POPQ pelvic organ prolapse classification system in INTERNATIONAL UROGYNECOLOGY JOURNAL
  • 2012-04-05. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for reporting outcomes of surgical procedures for pelvic organ prolapse in INTERNATIONAL UROGYNECOLOGY JOURNAL
  • 2013-06-18. Pyogenic spondylodiscitis associated with sacral colpopexy and rectopexy: report of two cases and evaluation of the literature in INTERNATIONAL UROGYNECOLOGY JOURNAL
  • 2013-10-19. Uterine-preserving POP surgery in INTERNATIONAL UROGYNECOLOGY JOURNAL
  • 2013-10-19. Epidemiology and outcome assessment of pelvic organ prolapse in INTERNATIONAL UROGYNECOLOGY JOURNAL
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    https://www.ncbi.nlm.nih.gov/pubmed/28417156


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