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Laparoscopic uterosacral ligament colpopexy for apical support in addition to hysterectomy for pelvic organ prolapse
Author(s) -
Nishimura Kazuaki,
Yoshimura Kazuaki,
Hoshino Kaori,
Myoga Mai,
Kubo Tatsuhiko,
Hachisuga Toru
Publication year - 2019
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.14005
Subject(s) - medicine , uterosacral ligament , surgery , perioperative , hysterectomy , stage (stratigraphy) , uterine prolapse , laparoscopy , retrospective cohort study , vagina , paleontology , biology
Aim To evaluate the perioperative complications and the anatomical outcomes of our laparoscopic uterosacral ligament (USL) colpopexy, which is a novel laparoscopic technique for the management of uterine prolapse. The objective was to report on outcome after 2 years of a technique using laparoscopic USL colpopexy. Methods A total of 152 uterine prolapse patients underwent laparoscopic USL colpopexy from May 2013 to April 2015. We described the surgical technique and performed a retrospective analysis of this laparoscopic technique. Patients underwent standardized assessment and examination using pelvic organ prolapse quantification (POP‐Q) score. The dependent values of Ba point (bladder), C point (vaginal cuff) and Bp point (rectum) were recorded preoperatively, and at 1, 3, 6, 12 and 24 months of postoperative examination. Pre/postoperative data were compared using the Kaplan–Meier method. Results Mean age, operative time and amount of hemorrhage were 68.2 ± 7.5 years, 118.3 ± 36.4 min and 60.5 ± 73.3 mL, respectively. Overall recurrent prolapse, which was defined as POP‐Q stage II or higher, was noted in 29 patients (19%). However, only 2 patients presented recurrent rectocele among 51 patients with preoperative POP‐Q stage II of uterine prolapse alone (recurrence rate; 3.9%). The pre/postoperative average POP‐Q scores were −0.2/−2.7 cm ( P < 0.05) at Ba point, −1.9/−5.1 cm ( P < 0.05) at C point and −2.4/−2.3 cm ( P = 0.06) at Bp point. Conclusion Laparoscopic visualization of uterosacral ligaments may result in safe colpopexy. Our results show this will be a useful procedure for apical support as native tissue repair.