Yisong Chen1, Keqin Hua2. 1. Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, China. 2. Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
Abstract
OBJECTIVE: To compare laparoscopic sacrocolpopexy (LSC) or sacrohysteropexy (LSH) with vaginal sacrospinous ligament fixation (VSSLF) for middle compartment pelvic organ prolapse (POP). METHODS: Data were retrospectively reviewed from patients with POP (stage 3 or worse) who underwent LSC, LSH, or VSSLF at a center in Shanghai between January 2009 and March 2014. POP quantification (POP-Q) and Pelvic Floor Distress Inventory scores were compared at the 2-year follow-up. RESULTS: Data were available for the 2-year follow-up for 102 LSC, 11 LSH, and 94 VSSLF procedures. Compared with patients who had undergone VSSLF, those who had undergone LSC/LSH had better POP-Q C values (P<0.001), longer total vaginal length (TVL) (P<0.001), and lower Aa and Ba scores (P=0.003 and P=0.002, respectively). Apical compartment and overall success rates of LSC/LSH and VSSLF did not differ significantly. Quality of life was improved in both groups (P<0.001). Both groups achieved symptomatic relief, although bowel and urinary functions were significantly improved only in the VSSLF group (P<0.001 for both). More patients in the LSC/LSH group were sexually active at 2 years (P<0.001); improvement in sex life was similar between the groups. CONCLUSION: Although LSC/LSH achieved longer TVL, both groups achieved the same success rate and improvement in quality of life. Specifically, VSSLF yielded a significant improvement in bowel and urinary function.
OBJECTIVE: To compare laparoscopic sacrocolpopexy (LSC) or sacrohysteropexy (LSH) with vaginal sacrospinous ligament fixation (VSSLF) for middle compartment pelvic organ prolapse (POP). METHODS: Data were retrospectively reviewed from patients with POP (stage 3 or worse) who underwent LSC, LSH, or VSSLF at a center in Shanghai between January 2009 and March 2014. POP quantification (POP-Q) and Pelvic Floor Distress Inventory scores were compared at the 2-year follow-up. RESULTS: Data were available for the 2-year follow-up for 102 LSC, 11 LSH, and 94 VSSLF procedures. Compared with patients who had undergone VSSLF, those who had undergone LSC/LSH had better POP-Q C values (P<0.001), longer total vaginal length (TVL) (P<0.001), and lower Aa and Ba scores (P=0.003 and P=0.002, respectively). Apical compartment and overall success rates of LSC/LSH and VSSLF did not differ significantly. Quality of life was improved in both groups (P<0.001). Both groups achieved symptomatic relief, although bowel and urinary functions were significantly improved only in the VSSLF group (P<0.001 for both). More patients in the LSC/LSH group were sexually active at 2 years (P<0.001); improvement in sex life was similar between the groups. CONCLUSION: Although LSC/LSH achieved longer TVL, both groups achieved the same success rate and improvement in quality of life. Specifically, VSSLF yielded a significant improvement in bowel and urinary function.
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