Esther Ruess1, Jan-Paul Roovers2, Stephen Jeffery3. 1. Department of Obstetrics and Gynaecology, University of Cape Town, Cape Town, South Africa. ruess.esther@gmail.com. 2. Department of Obstetrics and Gynaecology, Academic Medical Centre, Amsterdam, The Netherlands. 3. Department of Obstetrics and Gynaecology, University of Cape Town, Cape Town, South Africa.
Abstract
INTRODUCTION: The aim of this video case series is to demonstrate our experience with the surgical management of recurrent pelvic organ prolapse after sacrocolpopexy. METHODS: This is a series of seven patients who developed recurrent pelvic organ prolapse stage 2 or greater after sacrocolpopexy. The video shows short clips on the individualized surgical management using a laparoscopic approach. CONCLUSION: The surgical management of patients with recurrent pelvic organ prolapse poses a great challenge. In our cases the laparoscopic approach gave us the opportunity to diagnose the reason for surgical failure, to optimally restore the anatomy and function of the pelvic floor, and to limit the morbidity that is often seen in repeat surgery. Laparoscopic revision of sacrocolpopexy for recurrent pelvic organ prolapse is feasible but needs to be individualized. As the number of cases is limited, and available evidence is scarce, we recommend the use of a registry to prospectively follow up these patients and identify best practices.
INTRODUCTION: The aim of this video case series is to demonstrate our experience with the surgical management of recurrent pelvic organ prolapse after sacrocolpopexy. METHODS: This is a series of seven patients who developed recurrent pelvic organ prolapse stage 2 or greater after sacrocolpopexy. The video shows short clips on the individualized surgical management using a laparoscopic approach. CONCLUSION: The surgical management of patients with recurrent pelvic organ prolapse poses a great challenge. In our cases the laparoscopic approach gave us the opportunity to diagnose the reason for surgical failure, to optimally restore the anatomy and function of the pelvic floor, and to limit the morbidity that is often seen in repeat surgery. Laparoscopic revision of sacrocolpopexy for recurrent pelvic organ prolapse is feasible but needs to be individualized. As the number of cases is limited, and available evidence is scarce, we recommend the use of a registry to prospectively follow up these patients and identify best practices.