David Vandendriessche1, Julie Sussfeld2, Géraldine Giraudet2, Jean-Philippe Lucot2, Hélène Behal3, Michel Cosson2. 1. Gynecological Surgery Unit, Jeanne de Flandre Hospital, University Hospital of Lille, Lille, France. vdddv@live.fr. 2. Gynecological Surgery Unit, Jeanne de Flandre Hospital, University Hospital of Lille, Lille, France. 3. Methodology and Biostatistics Unit, EA2694, UDSL2, University Lille Nord de France, University Hospital of Lille, Lille, France.
Abstract
INTRODUCTION AND HYPOTHESIS: There is a lack of knowledge concerning long-term reoperation and complications after laparoscopic sacrocolpopexy (LSCP). We analyzed the rates and indications and potential risk factors for reoperation after LSCP in a large series of consecutive patients. METHODS: This was a single-center, retrospective study including all patients who underwent LSCP between 2003 and 2013. Data regarding pelvic organ prolapse (POP), surgical modalities and perioperative complications were collected. Patients were then contacted by telephone or postal letter in 2014. The main outcome criteria were grade III Dindo classification complications: reoperation for POP recurrence, mesh complications, and urinary incontinence (UI). RESULTS: Between January 2003 and December 2013, a total of 464 consecutive patients (mean age, 59 years) underwent LSCP. Almost all (99.1 %) patients presented with POP ≥ grade 3 (POP-Q classification). Long-term evaluations were completed for 391 (84.1 %) patients. The median follow-up was 53.5 ± 28.2 months. The global reoperation rate was 12.5 %. The main reoperation indications were UI-related surgery in 21 patients (5.5 %), POP recurrence surgery in 20 patients (5.1 %), and mesh-related surgery in 11 patients (2.8 %). Multivariate analysis showed that older age at the time of initial surgery and concomitant subtotal hysterectomy were significant protective factors against global reoperation (HR = 0.606, CI 95 % [0.451-0.815] and 0.367, CI 95 % [0.193-0.698] respectively) and reduced the risk of POP recurrence surgery. CONCLUSION: Prolapse recurrence and mesh-related surgery occurred in 5.1 and 2.8 % of patients respectively, 4 years after laparoscopic sacrocolpopexy. Age and concomitant subtotal hysterectomy could play a role in the incidence of long-term reoperation.
INTRODUCTION AND HYPOTHESIS: There is a lack of knowledge concerning long-term reoperation and complications after laparoscopic sacrocolpopexy (LSCP). We analyzed the rates and indications and potential risk factors for reoperation after LSCP in a large series of consecutive patients. METHODS: This was a single-center, retrospective study including all patients who underwent LSCP between 2003 and 2013. Data regarding pelvic organ prolapse (POP), surgical modalities and perioperative complications were collected. Patients were then contacted by telephone or postal letter in 2014. The main outcome criteria were grade III Dindo classification complications: reoperation for POP recurrence, mesh complications, and urinary incontinence (UI). RESULTS: Between January 2003 and December 2013, a total of 464 consecutive patients (mean age, 59 years) underwent LSCP. Almost all (99.1 %) patients presented with POP ≥ grade 3 (POP-Q classification). Long-term evaluations were completed for 391 (84.1 %) patients. The median follow-up was 53.5 ± 28.2 months. The global reoperation rate was 12.5 %. The main reoperation indications were UI-related surgery in 21 patients (5.5 %), POP recurrence surgery in 20 patients (5.1 %), and mesh-related surgery in 11 patients (2.8 %). Multivariate analysis showed that older age at the time of initial surgery and concomitant subtotal hysterectomy were significant protective factors against global reoperation (HR = 0.606, CI 95 % [0.451-0.815] and 0.367, CI 95 % [0.193-0.698] respectively) and reduced the risk of POP recurrence surgery. CONCLUSION: Prolapse recurrence and mesh-related surgery occurred in 5.1 and 2.8 % of patients respectively, 4 years after laparoscopic sacrocolpopexy. Age and concomitant subtotal hysterectomy could play a role in the incidence of long-term reoperation.
Entities:
Keywords:
Complication; Laparoscopic sacrocolpopexy; Long term; Prolapse; Reoperation
Authors: Julien Bacle; Athanasios G Papatsoris; Pierre Bigot; Abdel-Rahmene Azzouzi; Pierre-Emmanuel Brychaet; Jean Piussan; Eric Mandron Journal: Int J Urol Date: 2011-09-14 Impact factor: 3.369
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: Anne-Lotte W M Coolen; Anique M J van Oudheusden; Hugo W F van Eijndhoven; Tim P F M van der Heijden; Rutger A Stokmans; Ben Willem J Mol; Marlies Y Bongers Journal: Obstet Gynecol Int Date: 2013-09-26
Authors: Alexandra Dubinskaya; Diego Hernandez-Aranda; Dorothy B Wakefield; Jonathan P Shepherd Journal: Int Urogynecol J Date: 2019-06-29 Impact factor: 2.894
Authors: C Emi Bretschneider; Charles D Scales; Oyomoare Osazuwa-Peters; David Sheyn; Vivian Sung Journal: Int Urogynecol J Date: 2022-06-04 Impact factor: 1.932
Authors: Emily R W Davidson; Tonya N Thomas; Erika J Lampert; Marie Fidela R Paraiso; Cecile A Ferrando Journal: Int Urogynecol J Date: 2018-10-18 Impact factor: 2.894
Authors: Femke van Zanten; Jan J van Iersel; Tim J C Paulides; Paul M Verheijen; Ivo A M J Broeders; Esther C J Consten; Egbert Lenters; Steven E Schraffordt Koops Journal: Int Urogynecol J Date: 2019-06-20 Impact factor: 2.894
Authors: Slater A Jameson; Ganesh Swaminathan; Shataakshi Dahal; Bruna Couri; Mei Kuang; Anna Rietsch; Robert S Butler; Anand Ramamurthi; Margot S Damaser Journal: Physiol Rep Date: 2020-06