Evaluation on clinical effectiveness of modified laparoscopic sacral colpopexy / 中华妇产科杂志

ABSTRACT

Objective To study clinical curative effect and complications of modified laparoscopic sacral colpopexy and evaluate the efficacy and safety of this procedure in treatment of pelvic organ prolapse (POP).Methods From Jan.2008 to Sept.2012,66 patients who had undergone modified laparoscopic sacral colpopexy for POP in the first affiliated hospital of Guangzhou medical university were studied retrospectively.Primary outcomes were assessed with POP quantitation (POP-Q) system that was measured before or after operation respectively to evaluate the objective cure rate and recurrence rate.Secondary outcomes were measured by the pelvic floor distress inventory short form (PFDI-20) to evaluate the subjective cure rate,as well as to evaluate the improvement of postoperative lower urinary tract symptoms.Results Sixty-three patients were followed up for 6 to 57 months,and the median follow-up time was 16 months,the overall objective cure rate was 95％ (60/63).Postoperative each indicator point was reset anatomically according to POP-Q,the overall objective cure rate was 90％ (57/63),and the total recurrence rate was 10％ (6/63).The median postoperative vaginal length was slightly shortened than preoperative length[7.5 cm versus 8.0 cm,P ＜ 0.01]; the median score of postoperative PFDI-20 was obviously improved compared to the preoperative (21 versus 75 scores,P ＜ 0.05) ; there was no statistically significant difference in POP-Q staging and questionnaire score at more than 3 years,＞ 2-≤ 3 years,＞1-≤2 years,＜0.5-1 year after operation(P ＞0.05).Among 23 patients with stress urinary incontinence (SUI) and 5 patients with mixed urinary incontinence (MUI),15 cases underwent transvaginal tension free vaginal tape-obturator (TVT-O) procedure simultaneously,13 cases did not.The cure rate of SUI was 14/15 and 10/13,respectively.Conclusions Modified laparoscopic sacral colpopexy can not only reach the anatomical replacement stage but significantly improve the postoperative quality of life with high subjective and objective cure rate and few complications.The long-term curative effect is stable.