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Combined sacrospinous hysteropexy and cystopexy using a single anterior incision
Author(s) -
Petruzzelli Paolo,
Chiadò Fiorio Tin Michela,
Cosma Stefano,
Parisi Silvia,
Garofalo Anna,
Todros Tullia
Publication year - 2016
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2016.03.028
Subject(s) - medicine , surgery , uterine prolapse , quality of life (healthcare) , urinary system , prospective cohort study , stage (stratigraphy) , nursing , paleontology , biology
Objective To evaluate the safety, efficacy, and feasibility of a minimally invasive vaginal approach for treating advanced utero‐vaginal prolapse. Methods A prospective study enrolled consecutive patients attending the Gynecology and Obstetrics Department, Turin University for treatment of Pelvic Organ Prolapse Quantification (POP‐Q) stage III of higher symptomatic utero‐vaginal prolapse between February 1, 2013 and November 30, 2014. Participants underwent a combined sacrospinous hysteropexy and cystopexy procedure using a single anterior vaginal incision. Surgical procedures were performed by one of two surgeons, either an experienced senior surgeon or a resident surgeon under supervision. POP‐Q staging, patient symptoms, and quality of life were evaluated before and after surgery. Results The present study enrolled 42 patients and 19 (45%) were discharged on the first post‐operative day. The mean operating time was 40.5 ± 10.6 minutes and there was no significant difference in operating time between the two surgeons. With an average follow‐up duration of 13 months, significant post‐surgical improvements were recorded across both POP‐Q anterior ( P < 0.001) and apical ( P < 0.001) domains, and in both prolapse impact ( P < 0.001) and urinary impact ( P = 0.001) quality‐of‐life measures; one apical recurrence and no major complications were recorded. Conclusions Combined sacrospinous hysteropexy and cystopexy through a single incision appears to be a safe and efficacious procedure that was relatively easy for surgeons to learn and resulted in a fast post‐surgical recovery.