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. 2019 Apr;33(4):1075-1079.
doi: 10.1007/s00464-018-6357-z. Epub 2018 Jul 11.

Outcomes of laparoscopic management of multicompartmental pelvic organ prolapse

J C Martín Del Olmo  1   2 , M Toledano  3 , M L Martín Esteban  3 , M A Montenegro  3 , J R Gómez  3 , P Concejo  3 , M Rodríguez de Castro  4 , F Del Rio  5
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Outcomes of laparoscopic management of multicompartmental pelvic organ prolapse

J C Martín Del Olmo et al. Surg Endosc. 2019 Apr.

Abstract

Background: Pelvic organ prolapse (POP) is an increasing medical problem with complex diagnostics and controversial surgical management. It causes a series of dysfunctions in the gynecological, urinary, and anorectal organs. Numerous procedures have been proposed to treat these conditions, but in recent years, ventral mesh rectocolposacropexy (VMRCS) has emerged as the procedure of choice for the surgical treatment of POP, especially by a laparoscopic approach. This surgical technique limits the risk of autonomic nerve damage, and the colpopexy allows the correction of concomitant prolapse of the middle compartment. However, symptoms derived from anterior compartment prolapse remain a major morbidity and sometimes require an additional procedure. The aim of this study is to evaluate the results of laparoscopic prosthetic rectocolposacropexy (LRCS) and colposacropexy (LCS) procedures performed to manage combined multicompartmental POP.

Methods: Between November 2008 and December 2017, 38 patients with symptomatic POP underwent rectocolposacropexy (RCS) or colposacropexy (CS) by a laparoscopic approach. Demographics, mortality, morbidity, hospital stay, and functional outcomes were retrospectively analyzed.

Results: The median operating time was 200 min (IQR 160-220). Additional simultaneous surgery for POP was performed in nine cases: five suburethral slings and four hysterectomies were performed. No mortality was recorded. The conversion rate was 7.89%. There were two intraoperative complications (5.26%): one enterotomy and one urinary bladder tear. Late complications occurred in 5.26% of cases. After a mean follow-up of 20 months, constipation was completely resolved or improved in 83.33% of patients, urinary stress incontinence was resolved or improved in 52.94%, and gynecological symptomatology was resolved or improved in 93.75%. The recurrence rate was 5.26%.

Conclusions: Laparoscopic mesh rectocolposacropexy and colposacropexy are safe and effective techniques associated with very low morbidity. In the medium term, they provide good results for POP and associated symptoms, but urinary symptomology has a worse outcome.

Keywords: Colposacropexy; Laparoscopic rectopexy; Pelvic organ prolapse; Rectocolposacropexy.

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References

    1. Sagar PM, Thekkinkattil DK, Heath RM, Woodfield J, Gonsalves S, Landon CR (2008) Feasibility and functional outcome of laparoscopic sacrocolpopexy for combined vaginal and rectal prolapse. Disease Colon Rectum 51:1414–1420 - DOI
    1. Enríquez-Navascues JM, Elósegui JL, Apeztegui FJ, Placer C, Borda N, Irazusta M, Múgica JA, Murgpitio J (2009) Ventral rectal sacropexy (colpo-perineal) in the treatment of rectal and rectogenital prolapse. Cir Esp 86(5):283–298 - DOI - PubMed
    1. Samuelsson EC, Victor FT, Tibblin G, Svärdsudd KF (1999) Signs of genital prolapse in a Swedish population of women 20 to 59 years of age and possible related factors. Am J Obstet Gynecol 180:299–305 - DOI - PubMed
    1. Barber MD (2016) Pelvic organ prolapse. BMJ 354:i3853 - DOI - PubMed
    1. van Iersel JJ, de Witte CJ, Verheijen PM, Broeders IA, Lenters E, Consten EC, Schraffordt Koops SE (2016) Robot-assisted sacrocolporectopexy for multicompartment prolapse of the pelvic floor: a prospective cohort study evaluating functional and sexual outcome. Dis Colon Rectum 59(10):968–974 - DOI - PubMed

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