Laparoscopic sacral colpoperineopexy: abdominal versus abdominal–vaginal posterior graft attachment

• Published in: International Urogynecology Journal Vol. 22; no. 4; pp. 469 - 475
• Main Authors: McDermott, Colleen D., Park, Jean, Terry, Colin L., Woodman, Patrick J., Hale, Douglass S.
• Format: Journal Article
• Language: English
• Published: London Springer-Verlag 01-04-2011; Springer Nature B.V
• Subjects: Aged; Dyspareunia - epidemiology; Female; Foreign-Body Reaction - epidemiology; Gynecologic Surgical Procedures; Gynecology; Humans; Laparoscopy - methods; Medicine; Medicine & Public Health; Middle Aged; Original Article; Patient Satisfaction; Patient Selection; Pelvic Organ Prolapse - surgery; Perioperative Period; Postoperative Complications - epidemiology; Quality Assurance, Health Care; Recurrence; Retrospective Studies; Surgical Mesh; Urology; Mesh; Sacral colpoperineopexy; Posterior vaginal prolapse; Laparoscopic
• DOI: 10.1007/s00192-010-1302-2
• EISSN: 1433-3023
• ISSN: 0937-3462

Introduction and hypothesis
Laparoscopic sacral colpoperineopexy (LSCP) involves posterior graft extension to the perineum for improved posterior support. The objective of this study was to determine whether posterior measurements differed between those that had graft extension done abdominally (A-LSCP) or abdomino-vaginally (AV-LSCP).
Methods
This was a retrospective cohort study of patients that underwent A-LSCP (
n
 = 17) and AV-LSCP (
n
 = 51). Pre-, peri-, and postoperative variables were compared using Student’s
t
, Fisher’s exact, and analysis of covariance tests.
Results
Follow-up was 6 to 12 months. There were no differences between A-LSCP and AV-LSCP for any vaginal measurements or stage of prolapse (
P
 > 0.05). Although not statistically different, A-LSCP patients had lower rates of mesh erosion and dyspareunia (
P
 > 0.05). AV-LSCP patients had fewer prolapse symptoms (
P
 = 0.01), but both groups had similar surgical satisfaction (
P
 = 0.8).
Conclusions
A-LSCP and AV-LSCP had comparable effects on posterior vaginal measurements; however, mesh erosion and subjective outcomes differed between the two approaches.