A Minimally Invasive Technique for the 1-Stage Treatment of Complex Pelvic Floor Diseases: Laparoscopic-Pelvic Organ Prolapse Suspension

• Published in: Female pelvic medicine & reconstructive surgery Vol. 27; no. 1; pp. 28 - 33
• Main Authors: Boccasanta, Paolo, Venturi, Marco, Agradi, Sergio, Vergani, Contardo, Calabrò, Giuseppe, Missaglia, Claudio, Bordoni, Luca, Longo, Antonio
• Format: Journal Article
• Language: English
• Published: United States Lippincott Williams & Wilkins 01-01-2021; Copyright Wolters Kluwer Health, Inc. All rights reserved
• ISSN: 2151-8378; 2154-4212
• DOI: 10.1097/SPV.0000000000000722

OBJECTIVEThe aim of this prospective study was to assess the safety and effectiveness of a new single laparoscopic operation devised to relieve obstructed defecation, gynecologic and urinary symptoms in a large series of female patients with multiorgan pelvic prolapse.
METHODSWe submitted 384 female patients to laparoscopic pelvic organ prolapse suspension operation, a new technique based on suspension of the middle pelvic compartment, by using a polypropylene mesh and followed up 368 of them, with defecography performed 12 months after surgery and a standardized protocol.
RESULTSThe 368 patients were followed-up for 36.3 (±4.4) months, Recurrence rate was 4.9% for obstructed defecation syndrome and 3.3% for stress urinary incontinence. Complication rate was 2.9%. The mean period of daily activity resumption was 16.3 days (±4.8 days). Anorectal and urogynecologic symptoms and scores significantly improved after the operation (P < 0.001), with no worsening of anal continence. Incidence of postoperative fecal urgency was 0%. Postoperative defecography showed a significant (P < 0.001) improvement of all parameters in 315 patients (82%). Short Form 36 Health Survey score significantly improved after the operation (P < 0.01). An excellent/good overall Satisfaction Index was reported by 78.0% of patients.
CONCLUSIONSIn our experience the Laparoscopic-Pelvic Organ Prolapse Suspension seems to be safe and effective as a 1-stage treatment of associated pelvic floor diseases. Randomized studies with an appropriate control group and longer follow-up are now needed to assess the effectiveness of this promising technique.