A new operation technique for uterine prolapse: Vaginally-assisted laparoscopic sacrohysteropexy

Objective: To describe the new surgical technique and report the safety and feasibility of vaginally-assisted laparoscopic sacrohysteropexy (VALSH). Materials and Methods: Thirty-three women with stage 3 or more uterine prolapse underwent VALSH operation. Patients were followed up for 12 months for mesh-related complications and improvements of symptoms. The operation had three sections; 1st laparoscopic, 2nd vaginal, 3rd laparoscopic. Results: The mean age, gravidity, and parity of the study population were 46.5 years (range, 25-68 years), 4.3 (1-9), and 2.9 (1-6), respectively. The mean duration of operation was 59.5 min (range, 20-120 min). There were significant differences between the pre- and post-operative values of pelvic organ prolapse quantification parameters, which were favorable in the latter evaluation (p<0.001); total vaginal length was preserved after surgery (p>0.05). Conclusion: VALSH is a safe and minimally-invasive procedure in uterovaginal prolapse, with favorable anatomic and functional outcomes at 12 months post-operatively.

[1]  G. Cundiff,et al.  Vaginal and laparoscopic mesh hysteropexy for uterovaginal prolapse: a parallel cohort study , 2017, American journal of obstetrics and gynecology.

[2]  K. Nikolopoulos,et al.  Clinical outcomes in women undergoing laparoscopic hysteropexy: A systematic review. , 2017, European journal of obstetrics, gynecology, and reproductive biology.

[3]  C. Orhan,et al.  Turkish adaptation of the Pelvic Organ Prolapse Symptom Score and its validity and reliability , 2017, International Urogynecology Journal.

[4]  Julie Brown,et al.  Surgery for women with apical vaginal prolapse. , 2016, The Cochrane database of systematic reviews.

[5]  R. Gutman Does the uterus need to be removed to correct uterovaginal prolapse? , 2016, Current opinion in obstetrics & gynecology.

[6]  Yanzhou Wang,et al.  Laparoscopic sacral hysteropexy versus laparoscopic sacrocolpopexy with hysterectomy for pelvic organ prolapse , 2015, International Urogynecology Journal.

[7]  A. Fayyad,et al.  Safety and one year outcomes following vaginally assisted laparoscopic uterine sacropexy (VALUES) for advanced uterine prolapse , 2014, Neurourology and urodynamics.

[8]  P. Schluter,et al.  Uterine Preservation or Hysterectomy at Sacrospinous Colpopexy for Uterovaginal Prolapse? , 2014, International Urogynecology Journal.

[9]  G. Pignata,et al.  Efficacy of Laparoscopic Sacrocervicopexy for Apical Support of Pelvic Organ Prolapse , 2013, JSLS : Journal of the Society of Laparoendoscopic Surgeons.

[10]  Robert D Moore,et al.  Single-incision vaginal approach to treat cystocele and vault prolapse with an anterior wall mesh anchored apically to the sacrospinous ligaments , 2011, International Urogynecology Journal.

[11]  N. Price,et al.  Laparoscopic hysteropexy: the initial results of a uterine suspension procedure for uterovaginal prolapse , 2010, BJOG : an international journal of obstetrics and gynaecology.

[12]  Y. van der Graaf,et al.  One-year follow-up after sacrospinous hysteropexy and vaginal hysterectomy for uterine descent: a randomized study , 2009, International Urogynecology Journal.

[13]  M. Eijkemans,et al.  The prevalence of pelvic organ prolapse symptoms and signs and their relation with bladder and bowel disorders in a general female population , 2009, International Urogynecology Journal.

[14]  C. Maher,et al.  Efficacy and safety of transvaginal mesh kits in the treatment of prolapse of the vaginal apex: a systematic review , 2009, BJOG : an international journal of obstetrics and gynaecology.

[15]  V. Sung,et al.  Uterosacral colpopexy at the time of vaginal hysterectomy: comparison of laparoscopic and vaginal approaches. , 2007, The Journal of reproductive medicine.

[16]  A. Park,et al.  Surgical management of uterine prolapse. , 2008, Minerva ginecologica.

[17]  S. Narayanan Laparoscopic uterine sling suspension: a new technique of uterine suspension in women desiring surgical management of uterine prolapse with uterine conservation , 2008, BJOG : an international journal of obstetrics and gynaecology.

[18]  V. Bini,et al.  Uterus preservation in surgical correction of urogenital prolapse , 2005 .

[19]  S. Salvatore,et al.  The relationship of vaginal prolapse severity tosymptoms and quality of life , 2005, BJOG : an international journal of obstetrics and gynaecology.

[20]  V. Bini,et al.  Uterus preservation in surgical correction of urogenital prolapse. , 2003, European urology.

[21]  R. Seracchioli,et al.  Laparoscopic treatment of pelvic floor defects in women of reproductive age. , 2004, The Journal of the American Association of Gynecologic Laparoscopists.

[22]  X. Fritel,et al.  Abdominal sacrohysteropexy in young women with uterovaginal prolapse: long-term follow-up. , 2003, American journal of obstetrics and gynecology.

[23]  S. Bai,et al.  Relationship between Stress Urinary Incontinence and Pelvic Organ Prolapse , 2002, International Urogynecology Journal.

[24]  M. Carey,et al.  LAPAROSCOPIC SUTURE HYSTEROPEXY FOR UTERINE PROLAPSE , 2001, Obstetrics and gynecology.

[25]  M. Wu Laparoscopic uterine suspension for the treatment of uterovaginal prolapse , 1997, International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics.

[26]  L. Brubaker,et al.  The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. , 1996, American journal of obstetrics and gynecology.

[27]  J. Ibrahim,et al.  Failure of laparoscopic uterine suspension to provide a lasting cure for uterovaginal prolapse , 1994, British journal of obstetrics and gynaecology.

[28]  H. Peterson,et al.  Hysterectomy in the United States, 1988‐1990 , 1994, Obstetrics and gynecology.

[29]  D. Grimes,et al.  Hysterectomy in the United States , 1983, Obstetrics and gynecology.