Long term review of laparoscopic sacrocolpopexy

Abstract

Objective: Assessment of long term outcome following laparoscopic sacrocolpopexy.

Design: Retrospective follow up study using standardised examination with pelvic organ prolapse quantification system (POP-Q) and questionnaires.

Setting: A tertiary urogynaecology unit in the North West of England.

Population: One hundred and forty consecutive cases who had a laparoscopic sacrocolpopexy at St Mary's Hospital, Manchester, between 1993 and 1999.

Methods: Women completed questionnaires and were examined in gynaecology clinic or sent postal questionnaires if unable to attend the clinic.

Main outcome measures: Adequacy of vault support and recurrent vaginal prolapse assessed by POP-Q score. Assessment of prolapse, urinary and bowel symptoms and sexual function using questionnaires.

Results: One hundred and three women were contacted after a median of 66 months. Sixty-six women were examined and a further 37 women filled in questionnaires only. Recurrent vault prolapse occurred in 4 of the 66 women who were examined. Prolapse had recurred or persisted in 21 of 66 women, with equal numbers of anterior and posterior vaginal wall prolapse. Overall, 81/102 (79%) said that their symptoms of prolapse were 'cured' or 'improved'; 39/103 (38%) still had symptoms of prolapse. For every two women who were cured of their urinary or bowel symptoms, one woman developed worse symptoms.

Conclusions: Among the 66 women available for examination laparoscopic sacrocolpopexy provided good long term support of the vault in 92%. Forty-two percent of these women had recurrent vaginal wall prolapse. Despite this, 79% of women felt that their symptoms of prolapse were cured or improved following surgery.