Smita Rajshekhar1, Sambit Mukhopadhyay2, Edward Morris2. 1. Norfolk and Norwich University Hospital, Norwich, UK. Electronic address: smita.rajshekhar@yahoo.co.uk. 2. Norfolk and Norwich University Hospital, Norwich, UK.
Abstract
OBJECTIVE: To assess the safety and efficacy of a modified technique of bilateral abdominal sacrocolpopexy in which both uterosacral ligaments are replaced with polyvinylidene fluoride mesh to provide support to the cervix (cervico-sacropexy [CESA]) or vaginal vault (vagino-sacropexy [VASA]). METHODS: A retrospective observational study was undertaken of women with posthysterectomy vault prolapse or recurrent apical prolapse following previous prolapse repair who underwent bilateral sacrocolpopexy between July 1, 2013, and December 31, 2014, in a tertiary referral unit in the UK. Before surgery and 3 months afterwards, prolapse was assessed using the Pelvic Organ Prolapse Quantification scale and functional outcomes were recorded using the International Consultation on Incontinence Questionnaire for vaginal symptoms and urinary incontinence. RESULTS: Fifty women were included. At 3 months, 47 (94%) patients reported no bulge symptoms and the mean point C was -7.6. Complications comprised bladder injury in 1 (2%) and minor wound problems in 3 (6%) patients. No mesh erosion was reported. CONCLUSION: Bilateral abdominal sacrocolpopexy seems to be a safe and effective option for apical prolapse. Longer-term follow-up is needed to detect prolapse recurrence and mesh-related complications.
OBJECTIVE: To assess the safety and efficacy of a modified technique of bilateral abdominal sacrocolpopexy in which both uterosacral ligaments are replaced with polyvinylidene fluoride mesh to provide support to the cervix (cervico-sacropexy [CESA]) or vaginal vault (vagino-sacropexy [VASA]). METHODS: A retrospective observational study was undertaken of women with posthysterectomy vault prolapse or recurrent apical prolapse following previous prolapse repair who underwent bilateral sacrocolpopexy between July 1, 2013, and December 31, 2014, in a tertiary referral unit in the UK. Before surgery and 3 months afterwards, prolapse was assessed using the Pelvic Organ Prolapse Quantification scale and functional outcomes were recorded using the International Consultation on Incontinence Questionnaire for vaginal symptoms and urinary incontinence. RESULTS: Fifty women were included. At 3 months, 47 (94%) patients reported no bulge symptoms and the mean point C was -7.6. Complications comprised bladder injury in 1 (2%) and minor wound problems in 3 (6%) patients. No mesh erosion was reported. CONCLUSION: Bilateral abdominal sacrocolpopexy seems to be a safe and effective option for apical prolapse. Longer-term follow-up is needed to detect prolapse recurrence and mesh-related complications.