Zhiyuan Dai1, Chunbo Li2, Xipeng Wang2, Huimin Shu2, Kai Zhang3, Chenyun Dai4. 1. Department of Gynaecology and Obstetrics, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China. Electronic address: daizhiyuan@51mch.com. 2. Department of Gynaecology and Obstetrics, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China. 3. Department of Anatomy, Tongji University School of Medicine, Shanghai China. 4. Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Abstract
INTRODUCTION: The aim of the study was to evaluate the efficacy and safety of laparoscopic inguinal ligament suspension (LILS) as a new surgical technique for the treatment of vaginal vault prolapse. METHODS: From Feb 2014 to Mar 2016, 21 symptomatic women with grades III-IV vaginal vault prolapse were enrolled. All patients underwent LILS procedure in which a bifurcated mesh was used to suspend the vaginal vault to inguinal ligament. The perioperative parameters including surgical time, blood loss, and hospitalization time were recorded. At a minimal 12-month follow-up, the primary outcome measures, such as the anatomical cure rate and patients' satisfaction were respectively evaluated according to Pelvic organ prolapse questionnaire (POP-Q) and Patient Global Impression of Improvement (PGI-I) scale. The secondary outcomes including the impact on symptom severity, quality of life and sexual activity were also recorded. RESULTS: The mean surgical time was 130.71 ± 16.07 min, the mean estimated blood loss was 53.57 ± 48.43 ml, and the mean hospital stay was 6 days (range: 5-8 days). After a minimal 12-month follow-up (range: 12-36 months), the rate of anatomical success and the subjective satisfaction were 100% and 90.5%. The symptom severity, quality of life and sexual activity also presented significant improvement. In addition, no serious peri- and postoperative complications occurred. CONCLUSIONS: LILS was a potential method for the treatment of vaginal vault prolapse. The technique could be performed easily and might be an alternative to other POP surgeries. However, further studies were required to focus on its long-term efficacy.
INTRODUCTION: The aim of the study was to evaluate the efficacy and safety of laparoscopic inguinal ligament suspension (LILS) as a new surgical technique for the treatment of vaginal vault prolapse. METHODS: From Feb 2014 to Mar 2016, 21 symptomatic women with grades III-IV vaginal vault prolapse were enrolled. All patients underwent LILS procedure in which a bifurcated mesh was used to suspend the vaginal vault to inguinal ligament. The perioperative parameters including surgical time, blood loss, and hospitalization time were recorded. At a minimal 12-month follow-up, the primary outcome measures, such as the anatomical cure rate and patients' satisfaction were respectively evaluated according to Pelvic organ prolapse questionnaire (POP-Q) and Patient Global Impression of Improvement (PGI-I) scale. The secondary outcomes including the impact on symptom severity, quality of life and sexual activity were also recorded. RESULTS: The mean surgical time was 130.71 ± 16.07 min, the mean estimated blood loss was 53.57 ± 48.43 ml, and the mean hospital stay was 6 days (range: 5-8 days). After a minimal 12-month follow-up (range: 12-36 months), the rate of anatomical success and the subjective satisfaction were 100% and 90.5%. The symptom severity, quality of life and sexual activity also presented significant improvement. In addition, no serious peri- and postoperative complications occurred. CONCLUSIONS: LILS was a potential method for the treatment of vaginal vault prolapse. The technique could be performed easily and might be an alternative to other POP surgeries. However, further studies were required to focus on its long-term efficacy.