Long-term follow-up of laparoscopic sacrocolpopexy

Abstract

Introduction and hypothesis: This study evaluates the long-term results of laparoscopic sacrocolpopexy. In a prior publication, we demonstrated that laparoscopic sacrocolpopexy is a safe method with excellent anatomical results and low recurrence rates after a 12-month follow-up. This study now evaluates the long-term objectives and subjective outcomes of laparoscopic sacrocolpopexy after 5 years (mean).

Methods: From 2003 to 2007, a prospective study enrolling 101 patients was conducted to evaluate laparoscopic sacrocolpopexy as a treatment for pelvic organ prolapse. The long-term results were assessed postoperatively after 5 years by gynecological examinations, including the Pelvic Organ Prolapse Quantification (POP-Q) system and quality of life assessments using validated questionnaires.

Results: A total of 68 patients received a full clinical follow-up exam between July and September 2011, and 17 patients were assessed by questionnaires only. Altogether, six anatomical recurrences in the anterior, four in the posterior, and one in the apical compartment were found during the 5 years after surgery; 83.8 % of patients had no prolapse in any compartment or stage 0 prolapse according to the International Continence Society (ICS) classification. The total reoperation rate was 3.5 %. Two mesh erosions into the bladder occurred, though no vaginal erosion occurred. The preoperative quality of life index improved from 5.6 to 9.1 (12 months) and 8.3 (60 months) postoperatively, resulting in a subjective cure rate of 95.3 %.

Conclusions: Laparoscopic sacrocolpopexy has demonstrated excellent anatomical and functional long-term results. With the ongoing debate about the complications of vaginal mesh surgery, laparoscopic sacrocolpopexy should be considered a favorable treatment option for patients with pelvic organ prolapse.