Ke Pan1, Lili Cao1, Nicholas A Ryan2, Yanzhou Wang1, Huicheng Xu3. 1. Department of Obstetrics and Gynecology, Southwest Hospital, Third Military Medical University, Chongqing, 400038, China. 2. Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA. 3. Department of Obstetrics and Gynecology, Southwest Hospital, Third Military Medical University, Chongqing, 400038, China. huichengxu123@163.com.
Abstract
INTRODUCTION AND HYPOTHESIS: Treating pelvic organ prolapse (POP) with uterine conservation and sacral hysteropexy has uncertain subjective and objective outcomes. We sought to compare laparoscopic sacral hysteropexy with laparoscopic sacrocolpopexy/total laparoscopic hysterectomy (TLH with LSC). METHODS: Clinical data of 34 patients who underwent TLH with LSC and 65 patients who underwent laparoscopic sacral hysteropexy performed by the same group of surgeons between January 2008 and December 2013 were reviewed retrospectively. The primary outcome was subjective satisfaction rate based upon validated questionnaire (Patient Global Impression of Change [PGI-C]). Secondary outcomes were: anatomical cure, impact on quality of life based upon validated questionnaires (pelvic floor distress inventory-short form 20 [PFDI-20], Pelvic Floor Impact Questionnaire 7 [PFIQ-7], and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-12 [PISQ-12]), surgical complications, and cost. RESULTS: After a mean follow-up of 33 months, the subjective satisfaction rate was significantly higher in the TLH with LSC cohort (92.3% vs 100%; p < 0.001). The POP-Q scores in both groups were significantly improved postoperatively. However, the anatomical cure in the two groups (72.3% vs 88.2%; p = 0.07) did not differ significantly The postoperative PFIQ-7 and PFDI-20 scores were significantly better in the TLH with LSC cohort than in the laparoscopic sacral hysteropexy cohort (p = 0.043 and p = 0.035 respectively). CONCLUSIONS: Relative to laparoscopic sacral hysteropexy, the TLH with LSC approach provides similar anatomical results, excellent patient satisfaction, and improved quality of life scores.
INTRODUCTION AND HYPOTHESIS: Treating pelvic organ prolapse (POP) with uterine conservation and sacral hysteropexy has uncertain subjective and objective outcomes. We sought to compare laparoscopic sacral hysteropexy with laparoscopic sacrocolpopexy/total laparoscopic hysterectomy (TLH with LSC). METHODS: Clinical data of 34 patients who underwent TLH with LSC and 65 patients who underwent laparoscopic sacral hysteropexy performed by the same group of surgeons between January 2008 and December 2013 were reviewed retrospectively. The primary outcome was subjective satisfaction rate based upon validated questionnaire (Patient Global Impression of Change [PGI-C]). Secondary outcomes were: anatomical cure, impact on quality of life based upon validated questionnaires (pelvic floor distress inventory-short form 20 [PFDI-20], Pelvic Floor Impact Questionnaire 7 [PFIQ-7], and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-12 [PISQ-12]), surgical complications, and cost. RESULTS: After a mean follow-up of 33 months, the subjective satisfaction rate was significantly higher in the TLH with LSC cohort (92.3% vs 100%; p < 0.001). The POP-Q scores in both groups were significantly improved postoperatively. However, the anatomical cure in the two groups (72.3% vs 88.2%; p = 0.07) did not differ significantly The postoperative PFIQ-7 and PFDI-20 scores were significantly better in the TLH with LSC cohort than in the laparoscopic sacral hysteropexy cohort (p = 0.043 and p = 0.035 respectively). CONCLUSIONS: Relative to laparoscopic sacral hysteropexy, the TLH with LSC approach provides similar anatomical results, excellent patient satisfaction, and improved quality of life scores.
Authors: R C Bump; A Mattiasson; K Bø; L P Brubaker; J O DeLancey; P Klarskov; B L Shull; A R Smith Journal: Am J Obstet Gynecol Date: 1996-07 Impact factor: 8.661
Authors: Tatiana V D Sanses; Azin Shahryarinejad; Stephanie Molden; Kay A Hoskey; Shameem Abbasy; Danielle Patterson; Emily K Saks; Emily E Weber LeBrun; Tondalaya L Gamble; Virginia G King; Aimee L Nguyen; Husam Abed; Stephen B Young Journal: Am J Obstet Gynecol Date: 2009-08-28 Impact factor: 8.661
Authors: Danielle D Antosh; Stephanie A Grotzke; Marcela A McDonald; David Shveiky; Amy J Park; Robert E Gutman; Andrew I Sokol Journal: Female Pelvic Med Reconstr Surg Date: 2012 May-Jun Impact factor: 2.091
Authors: Nicole B Korbly; Nadine C Kassis; Meadow M Good; Monica L Richardson; Nicole M Book; Sallis Yip; Docile Saguan; Carey Gross; Janelle Evans; Vrishali V Lopes; Heidi S Harvie; Vivian W Sung Journal: Am J Obstet Gynecol Date: 2013-08-03 Impact factor: 8.661
Authors: Geoffrey W Cundiff; Edward Varner; Anthony G Visco; Halina M Zyczynski; Charles W Nager; Peggy A Norton; Joseph Schaffer; Morton B Brown; Linda Brubaker Journal: Am J Obstet Gynecol Date: 2008-10-31 Impact factor: 8.661
Authors: Jasmine Tan-Kim; Shawn A Menefee; Karl M Luber; Charles W Nager; Emily S Lukacz Journal: Int Urogynecol J Date: 2010-09-15 Impact factor: 2.894
Authors: Kimberly Kenton; Elizabeth R Mueller; Christopher Tarney; Catherine Bresee; Jennifer T Anger Journal: Female Pelvic Med Reconstr Surg Date: 2016 Sep-Oct Impact factor: 2.091
Authors: Ivan Ignjatovic; Milan Potic; Dragoslav Basic; Ljubomir Dinic; Aleksandar Skakic Journal: Int Urogynecol J Date: 2020-09-08 Impact factor: 2.894