Laparoscopic Sacrocolpopexy Versus Transvaginal Mesh Pelvic Floor Reconstruction Surgery for Treatment of Pelvic Organ Prolapse

Mengting Xia, Xiaojun Shi, Jiaxi Wang,Peiyu Mao, Shanshan Mei,Xinyan Wang

Indian Journal of Surgery(2024)

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摘要
The study aims to compare the objective and subjective outcomes of laparoscopic sacrocolpopexy (LSC) and transvaginal mesh (TVM) surgery. A retrospective study of 62 women with pelvic organ prolapse stage III and IV among patients who underwent LSC ( N = 30) and TVM ( N = 32). The pelvic floor quality of life questionnaires (PFDI-20, PFIQ-7, PISQ-12) and the pelvic organ prolapse quantification (POP-Q) were used to assess the subjective and objective outcomes, respectively. The intraoperative details and long-term surgery complications were assessed as well. The patients were reviewed after the operation for a gynecological examination, treatment, and functional outcomes evaluation. Compared to preoperative POP-Q measurement, except for PB and TVL, the postoperative objective outcomes improved significantly for the two groups ( P < 0.05). The postoperative mean for PB increased significantly in the TVM group than in the LSC group, 2.75 ± 0.49 Vs 2.45 ± 0.68, ( P = 0.04), and the postoperative mean for point C was more improved in LSC than in the TVM group, (− 5.68 ± 2.76 Vs − 5.59 ± 2.07), respectively. The PFDI-20 questionnaire shows that the post-operative subjective outcomes were significantly improved compared to preoperative status in LSC and TVM ( P < 0.05), except CRADI-8 questionnaire for LSC ( P = 0.4). The PFIQ-7 improved significantly in TVM ( P < 0.05), except CRAIQ-7 ( P = 0.5). However, there were no statistically significant in the LSC group ( P > 0.05). Patients who went for the LSC procedure had a longer operation time and greater blood loss than TVM. The TVM surgery offered a higher patient satisfaction for colorectal-anal symptoms than LSC. The patients who underwent LSC had a more extended operating time and greater blood loss, while those who underwent TVM had a higher rate of dyspareunia.
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关键词
Laparoscopic sacrocolpopexy,Pelvic organ prolapse,Transvaginal mesh
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