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Laparoscopic repair of vaginal vault prolapse by lateral suspension with mesh.
Arch Gynecol Obstet. 2013 Feb; 287(2):307-12.AG

Abstract

BACKGROUND

To evaluate the long-term outcomes of laparoscopic lateral suspension using mesh reinforcement for symptomatic posthysterectomy vaginal vault prolapse.

MATERIALS AND METHODS

We analyzed in a prospective cohort study all the women treated by laparoscopic lateral suspension with mesh for symptomatic vaginal vault prolapse between January 2004 and September 2010. In this procedure, the mesh is laterally suspended to the abdominal wall, posterior to the anterior superior iliac spine. We performed systematic follow-up examinations at 4 weeks, 6 months and yearly postoperatively. Clinical evaluation of pelvic organ support was assessed by the pelvic organ prolapse quantification (POP-Q) grading system. Main outcome measures were recurrence rate, reoperation rate for symptomatic recurrence or de novo prolapse, mesh erosion rate, reoperation rate for mesh erosion, total reoperation rate.

OBSERVATIONS AND RESULTS

Of the 73 patients seen at a mean 17.5 months follow-up, recurrent vaginal vault prolapse was registered in only one woman (success rate of 98.6 %). When considering all vaginal sites, we observed a total of 13 patients with recurrent or de novo prolapse (17.8 %). The non-previously treated posterior compartment was involved in eight cases (new appearance rate of 11 %). Of these 13 women, only 6 were symptomatic, requiring surgical management (reoperation rate for genital prolapse of 8.2 %). Four patients presented with mesh erosion into the vagina (5.5 %). Two required partial vaginal excision of the mesh in the operating room (2.7 %). There were no mesh-related infections. The total reoperation rate was 11 %.

CONCLUSION

Laparoscopic lateral suspension with mesh interposition is a safe and effective technique for the treatment of vaginal vault prolapse. This approach represents an alternative procedure to the laparoscopic sacrocolpopexy.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Dubuisson J
Perineology Unit, Division of Gynecology, Department of Obstetrics and Gynecology, University Hospitals of Geneva, 30 Boulevard de la Cluse, 1211, Geneva, Switzerland. neajdubuisson@yahoo.fr
Eperon I
No affiliation info available
Dällenbach P
No affiliation info available
Dubuisson JB
No affiliation info available

MeSH

AdultAgedAged, 80 and overFemaleFollow-Up StudiesGynecologic Surgical ProceduresHumansHysterectomyLaparoscopyMiddle AgedPelvic Organ ProlapsePostoperative ComplicationsProspective StudiesRecurrenceReoperationSurgical MeshTreatment Outcome

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

23001368

Citation

Dubuisson, Jean, et al. "Laparoscopic Repair of Vaginal Vault Prolapse By Lateral Suspension With Mesh." Archives of Gynecology and Obstetrics, vol. 287, no. 2, 2013, pp. 307-12.
Dubuisson J, Eperon I, Dällenbach P, et al. Laparoscopic repair of vaginal vault prolapse by lateral suspension with mesh. Arch Gynecol Obstet. 2013;287(2):307-12.
Dubuisson, J., Eperon, I., Dällenbach, P., & Dubuisson, J. B. (2013). Laparoscopic repair of vaginal vault prolapse by lateral suspension with mesh. Archives of Gynecology and Obstetrics, 287(2), 307-12. https://doi.org/10.1007/s00404-012-2574-1
Dubuisson J, et al. Laparoscopic Repair of Vaginal Vault Prolapse By Lateral Suspension With Mesh. Arch Gynecol Obstet. 2013;287(2):307-12. PubMed PMID: 23001368.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Laparoscopic repair of vaginal vault prolapse by lateral suspension with mesh. AU - Dubuisson,Jean, AU - Eperon,Isabelle, AU - Dällenbach,Patrick, AU - Dubuisson,Jean-Bernard, Y1 - 2012/09/22/ PY - 2012/06/14/received PY - 2012/09/11/accepted PY - 2012/9/25/entrez PY - 2012/9/25/pubmed PY - 2013/6/21/medline SP - 307 EP - 12 JF - Archives of gynecology and obstetrics JO - Arch Gynecol Obstet VL - 287 IS - 2 N2 - BACKGROUND: To evaluate the long-term outcomes of laparoscopic lateral suspension using mesh reinforcement for symptomatic posthysterectomy vaginal vault prolapse. MATERIALS AND METHODS: We analyzed in a prospective cohort study all the women treated by laparoscopic lateral suspension with mesh for symptomatic vaginal vault prolapse between January 2004 and September 2010. In this procedure, the mesh is laterally suspended to the abdominal wall, posterior to the anterior superior iliac spine. We performed systematic follow-up examinations at 4 weeks, 6 months and yearly postoperatively. Clinical evaluation of pelvic organ support was assessed by the pelvic organ prolapse quantification (POP-Q) grading system. Main outcome measures were recurrence rate, reoperation rate for symptomatic recurrence or de novo prolapse, mesh erosion rate, reoperation rate for mesh erosion, total reoperation rate. OBSERVATIONS AND RESULTS: Of the 73 patients seen at a mean 17.5 months follow-up, recurrent vaginal vault prolapse was registered in only one woman (success rate of 98.6 %). When considering all vaginal sites, we observed a total of 13 patients with recurrent or de novo prolapse (17.8 %). The non-previously treated posterior compartment was involved in eight cases (new appearance rate of 11 %). Of these 13 women, only 6 were symptomatic, requiring surgical management (reoperation rate for genital prolapse of 8.2 %). Four patients presented with mesh erosion into the vagina (5.5 %). Two required partial vaginal excision of the mesh in the operating room (2.7 %). There were no mesh-related infections. The total reoperation rate was 11 %. CONCLUSION: Laparoscopic lateral suspension with mesh interposition is a safe and effective technique for the treatment of vaginal vault prolapse. This approach represents an alternative procedure to the laparoscopic sacrocolpopexy. SN - 1432-0711 UR - https://www.unboundmedicine.com/medline/citation/23001368/Laparoscopic_repair_of_vaginal_vault_prolapse_by_lateral_suspension_with_mesh_ L2 - https://dx.doi.org/10.1007/s00404-012-2574-1 DB - PRIME DP - Unbound Medicine ER -