Laparoscopic treatment of women with severe pelvic organ prolapse

Αthanasiou S, Grigoriadis T, Protopapas Α, Liapi Α, Chatzipapas Ι, Miligos S, Αntsaklis Α.

Department of Urogynecology, 1st Department of Obstetrics & Gynecology, University of Athens, «Αlexandra» Hospital, Greece

Correspondence: Athanasiou S, Department of Urogynecology, 1st Department of Obstetrics & Gynecology,

University of Athens, «Αlexandra» Hospital, 115 25, Athens, Greece.

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Abstract

Objective of the study was to assess the efficacy of laparoscopic treatment for women with severe pelvic organ prolapse. It was a prospective follow up study of women with
severe prolapse of the pelvic apical compartment that underwent laparoscopic treatment. All patients were evaluated using the validated POP-Q system according to the International Continence Society and the King's Health Questionnaire (KHQ). A total of 27 women with grade ≥2 POP-Q pelvic organ prolapse underwent a combination of laparoscopic and vaginal suspension procedures. 12 out of 22 women with uterus had laparoscopic sacrohysteropexy, whilst 10 underwent a total (laparoscopic or
vaginal) or subtotal (laparoscopic) hysterectomy and sacrocolpopexy. 5 women had a history of a hysterectomy and had a laparoscopic vaginal vault suspension. Concurrent procedures included: 18 cases of tension free vaginal tape (TVT or TVT-O), 20 cases of anterior/posterior colporrhaphy and one laparoscopic repair of paravaginal defects. All women were examined at 6 months postoperatively. At follow-up there were no cases of recurrent apical prolapse and two women had an asymptomatic grade 2 cystocele. There was an improvement of all scales of KHQ. The combination of laparoscopic and vaginal surgery appears to be a safe and effective approach for the treatment and improvement of the quality of life of women with severe pelvic organ prolapse, at least on the short term.

Key words: laparoscopy; sacrocolpopexy; prolapse of pelvic organs.