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Olson CH, Bordeianou L, Perry WRG, Mellgren A, Wells KKO, Ferrari L, Oliveira L, Spivak AR, Ratto C, Gurland BH. Development of a Consensus-Derived Synoptic Operative Report for Rectal Prolapse: A Report From the Pelvic Floor Disorders Consortium. Dis Colon Rectum 2024; 67:1169-1176. [PMID: 38830262 DOI: 10.1097/dcr.0000000000003364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
BACKGROUND Narrative operative reports may omit or obscure data from an operation. OBJECTIVE To develop a synoptic operative report for rectal prolapse that includes core descriptors as developed by an international consensus of expert pelvic floor surgeons. DESIGN Descriptors for patients undergoing rectal prolapse surgery were generated through review. Members of the Pelvic Floor Disorders Consortium were recruited to participate in a 3-round Delphi process using a 9-point Likert scale. Descriptors that achieved 70% agreement were kept from the first round, and descriptors scoring 40% to 70% agreement were recirculated in subsequent rounds. A final list of operative descriptors was determined at a consensus meeting, with a final consensus meeting more than 70% agreement. SETTINGS This survey was administered to members of the Pelvic Floor Disorders Consortium. PATIENTS No patient data are included in this study. MAIN OUTCOME MEASURES Descriptors meeting greater than 70% agreement were selected. RESULTS One hundred seventy-six surgeons representing colorectal surgeons, urogynecologists, and urologists distributed throughout North America (56%), Latin America (4%), Western Europe (29%), Asia (4%), and Africa (1%) participated in the first round of Delphi voting. After 2 additional rounds and a final consensus meeting, 16 of 30 descriptors met 70% consensus. Descriptors that met consensus were surgery type, posterior dissection, ventral dissection, mesh used, type of mesh used, mesh location, sutures used, suture type, pouch of Douglas and peritoneum reclosed, length of rectum imbricated, length of bowel resected, levatoroplasty, simultaneous vaginal procedure, simultaneous gynecologic procedure, simultaneous enterocele repair, and simultaneous urinary incontinence procedure. LIMITATIONS The survey represents the views of members of the Delphi panel and may not represent the viewpoints of all surgeons. CONCLUSIONS This Delphi survey establishes international consensus descriptors for intraoperative variables that have been used to produce a synoptic operative report. This will help establish defined operative reporting to improve clinical communication, quality measures, and clinical research. See Video Abstract . DESARROLLO DE UN PROTOCOLO OPERATORIO SINPTICO DERIVADO DE CONSENSO PARA EL PROLAPSO RECTAL UN INFORME DEL CONSORCIO DE TRASTORNOS DEL PISO PLVICO ANTECEDENTES:Los protocolos operativos narrativos frecuentemente pueden omitir u oscurecer datos de un procedimiento.OBJETIVO:Nuestro objetivo es desarrollar un protocolo operatorio sinóptico para el prolapso rectal que incluya descriptores básicos desarrollados por un consenso internacional de cirujanos expertos en piso pélvico.DISEÑO:Los descriptores para pacientes sometidos a cirugía de prolapso rectal se generaron mediante revisión. Se reclutó a miembros del Consorcio de Trastornos del Piso Pélvico para participar en un proceso Delphi de 3 rondas utilizando una escala Likert de 9 puntos. Los descriptores que lograron un 70% de acuerdo se mantuvieron en la primera ronda, los descriptores que obtuvieron un 40-70% de acuerdo se recircularon en rondas posteriores. Se determinó una lista final de descriptores operativos en una reunión de consenso, con una reunión de consenso final de más del 70% de acuerdo.ESCENARIO:Esta fue una encuesta administrada a miembros del Consorcio de Trastornos del Piso Pélvico.PRINCIPALES MEDIDAS DE RESULTADO:Se seleccionaron los descriptores que cumplieron más del 70% de acuerdo.RESULTADOS:Ciento setenta y seis cirujanos en representación de cirujanos colorrectales, uroginecólogos y urólogos distribuidos en América del Norte (56%), América Latina (4%), Europa Occidental (29%), Asia (4%) y África (1%) participaron en la primera ronda de votación Delphi. Después de dos rondas adicionales y una reunión de consenso final, 16 de 30 descriptores alcanzaron un 70% de consenso. Los descriptores que alcanzaron consenso fueron: tipo de cirugía, disección posterior, disección ventral, malla utilizada, tipo de malla utilizada, ubicación de la malla, suturas utilizadas, tipo de sutura, cierre del fondo de saco de Douglas y peritoneo, longitud del recto superpuesto, longitud del intestino resecado, plastía de los elevadores , procedimiento vaginal simultáneo, procedimiento ginecológico simultáneo, reparación simultánea de enterocele y procedimiento simultáneo de incontinencia urinaria.LIMITACIONES:La encuesta representa las opiniones de los miembros del panel Delphi y puede no representar los puntos de vista de todos los cirujanos.CONCLUSIONES/DISCUSIÓN:Esta encuesta Delphi establece descriptores de consenso internacional para las variables intraoperatorias que se han utilizado para producir un protocolo operatorio sinóptico. Esto ayudará a establecer protocolos operativos definidos para mejorar la comunicación clínica, las medidas de calidad y la investigación clínica. (Traducción-Dr. Felipe Bellolio ).
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Affiliation(s)
- Craig H Olson
- Texas A&M School of Medicine, Baylor Scott and White Medical Center, Waxahachie, Texas
| | - Lilliana Bordeianou
- Section of Colorectal Surgery, Massachusetts General Hospital Pelvic Floor Disorders Center, Harvard Medical School, Boston, Massachusetts
| | - William R G Perry
- Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota
| | - Anders Mellgren
- University of Illinois College of Medicine, Chicago, Illinois
| | - Katerina K O Wells
- Division of Colon and Rectal Surgery, Baylor University Medical Center, Dallas, Texas
| | - Linda Ferrari
- Guy's and St Thomas' Hospital National Health Service, London, United Kingdom
| | - Lucia Oliveira
- Director, Anorectal Physiology Department, Casa de Saude Sao Jose: Casa de Saude, Rio De Janeiro, Brazil
| | - Anna R Spivak
- Department of Colorectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, Ohio
| | - Carlo Ratto
- Proctology Unit, Universita Cattolica del Sacro Cuore, Roma, Italy
| | - Brooke Heidi Gurland
- Division of Colorectal Surgery, Department of Surgery, Stanford College of Medicine, Stanford, California
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Gee AD, Lee SK, Ban K, Paraiso MFR. The Current Evidence and How-To on Combined Sacrocolpopexy and Rectopexy. Int Urogynecol J 2024:10.1007/s00192-024-05869-2. [PMID: 39090473 DOI: 10.1007/s00192-024-05869-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 06/20/2024] [Indexed: 08/04/2024]
Abstract
INTRODUCTION AND HYPOTHESIS Multicompartment prolapse is a complex pelvic floor condition that can involve coordination of both urogynecologists and colorectal surgeons. METHODS Concomitant sacrocolpopexy and ventral rectopexy is a safe and effective approach to treating this condition. RESULTS The combined procedure has high rates of patient satisfaction and symptom improvement, including defecatory dysfunction, sexual health, and overall increased quality of life. CONCLUSION Concomitant sacrocolpopexy with ventral rectopexy is safe and improves overall outcomes.
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Affiliation(s)
- Amy D Gee
- Department of Urogynecology, Cleveland Clinic, 9500 Euclid Ave, A81, Cleveland, OH, 44195, USA.
| | - Sunny Kairi Lee
- Department of Urogynecology, Cleveland Clinic, 9500 Euclid Ave, A81, Cleveland, OH, 44195, USA
| | - Kristen Ban
- Department of Colorectal Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Marie Fidela R Paraiso
- Department of Urogynecology, Cleveland Clinic, 9500 Euclid Ave, A81, Cleveland, OH, 44195, USA
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Guo J, Song X, Liang S, Wang Y, Ye Y, Gao Q, Chen J, Zhu L. Laparoscopic sacrocolpopexy for treatment of pelvic organ prolapse, a prospective observation cohort with follow-up time over 7 years. Chin Med J (Engl) 2024; 137:1477-1479. [PMID: 37962179 PMCID: PMC11188854 DOI: 10.1097/cm9.0000000000002835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Indexed: 11/15/2023] Open
Affiliation(s)
| | | | | | | | | | | | - Juan Chen
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing 100730, China
| | - Lan Zhu
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing 100730, China
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Lua-Mailland LL, Stanley EE, Yao M, Paraiso MFR, Wallace SL, Ferrando CA. Healthcare Resource Utilization Following Minimally Invasive Sacrocolpopexy: Impact of Concomitant Rectopexy. Int Urogynecol J 2024; 35:1001-1010. [PMID: 38416154 DOI: 10.1007/s00192-024-05748-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 01/30/2024] [Indexed: 02/29/2024]
Abstract
INTRODUCTION AND HYPOTHESIS Combined surgical procedures with sacrocolpopexy (SCP) and rectopexy (RP) are more commonly being performed for treatment of multicompartment pelvic organ prolapse. This study aimed to compare healthcare resource utilization (HRU) within 6 weeks following combined surgery (SCP-RP) versus SCP alone (SCP-only). We hypothesized that concomitant RP does not impact HRU. METHODS A retrospective cohort study of patients who underwent minimally invasive SCP from 2017 to 2022 was conducted at a tertiary referral center. Patients were grouped based on the performance of concomitant RP. HRU was defined as a composite of unscheduled office visits, emergency department visits, and readmissions before the 6-week postoperative visit. HRU was compared in the SCP-RP and SCP-only groups. Multivariable regression analysis was performed to identify factors associated with HRU. RESULTS There were 144 patients in the SCP-RP group and 405 patients in the SCP-only group. Patient characteristics were similar between the two groups, with the following exceptions: the SCP-RP group was older, more likely to have comorbid conditions, and live >60 miles from the hospital. Of the 549 patients, 183 (33.3%) had ≥1 HRU encounter within 6 weeks after surgery. However, there was no difference between the SCP-RP and SCP-only groups in composite HRU (34.0% vs 33.1%, p = 0.84). The most common reasons for HRU were pain, urinary tract infection symptoms, and wound issues. Concomitant mid-urethral sling was associated with a two-fold increased risk of HRU after surgery. CONCLUSIONS One in 3 patients undergoing minimally invasive SCP had at least one unanticipated encounter within 6 weeks after surgery. Concomitant RP was not associated with increased postoperative HRU.
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Affiliation(s)
- Lannah L Lua-Mailland
- Section of Urogynecology and Reconstructive Pelvic Surgery, Obstetrics and Gynecology Institute, 9500 Euclid Avenue, A81, Cleveland, OH, 44195, USA.
| | - Elizabeth E Stanley
- Section of Urogynecology and Reconstructive Pelvic Surgery, Obstetrics and Gynecology Institute, 9500 Euclid Avenue, A81, Cleveland, OH, 44195, USA
| | - Meng Yao
- Department of Quantitative Health Sciences, Section of Biostatistics, Cleveland Clinic, Cleveland, OH, USA
| | - Marie Fidela R Paraiso
- Section of Urogynecology and Reconstructive Pelvic Surgery, Obstetrics and Gynecology Institute, 9500 Euclid Avenue, A81, Cleveland, OH, 44195, USA
| | - Shannon L Wallace
- Section of Urogynecology and Reconstructive Pelvic Surgery, Obstetrics and Gynecology Institute, 9500 Euclid Avenue, A81, Cleveland, OH, 44195, USA
| | - Cecile A Ferrando
- Section of Urogynecology and Reconstructive Pelvic Surgery, Obstetrics and Gynecology Institute, 9500 Euclid Avenue, A81, Cleveland, OH, 44195, USA
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Najib B, Rusavy Z, Abdallah W, Deval B. Laparoscopic sacrocolpopexy in the management of recurrent pelvic organ prolapse. J Gynecol Obstet Hum Reprod 2023; 52:102651. [PMID: 37625697 DOI: 10.1016/j.jogoh.2023.102651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 07/26/2023] [Accepted: 08/21/2023] [Indexed: 08/27/2023]
Abstract
OBJECTIVES We set out to assess long-term anatomical and functional outcomes in women after laparoscopic sacrocolpopexy for recurrent pelvic organ prolapse. METHODS All women with a history of pelvic organ prolapse surgery operated between 2005 and 2022 were enrolled in this retrospective observational study. The indication for recurrent POP surgery was a symptomatic stage II and above pelvic organ prolapse. The data from objective urogynecologic examination and subjective patient assessment using validated questionnaires were collected. The last follow-up information was evaluated. The outcomes were compared with preoperative state using Student t-test and Wilcoxon test, p<0.05 was considered significant. RESULTS 39 women were enrolled in the study. The rate of perioperative complications was very low; no significant hemorrhage, ureteral damage or conversion to laparotomy were observed. The mean follow-up was 40 ± 26.8 months. The postoperative course was not complicated by bowel incarceration, pelvic infection or mesh exposure. We observed a statistically significant elevation of all POP-Q points and decrease in all mean scores of PFDI, PFIQ, Wexner and VAS prolapse bother postoperatively. Improvement in stress urinary incontinence, anal incontinence and constipation was found. CONCLUSIONS Laparoscopic sacrocolpopexy for recurrent pelvic organ prolapse is a safe and effective surgery regardless of the type of the original repair performed. It provides good subjective and anatomical outcomes with a lasting effect on the quality of life in a long-term follow-up.
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Affiliation(s)
- Bernard Najib
- Department of Functional Pelvic Surgery & Oncology, Geoffroy Saint-Hilaire, Ramsay, Générale de Santé, Paris, France; Department of Obstetrics and Gynaecology, Faculty of Medicine, Saint Joseph University, Beyrouth, Lebanon
| | - Zdenek Rusavy
- Department of Functional Pelvic Surgery & Oncology, Geoffroy Saint-Hilaire, Ramsay, Générale de Santé, Paris, France; Department of Obstetrics and Gynaecology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czechia.
| | - Wael Abdallah
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Saint Joseph University, Beyrouth, Lebanon
| | - Bruno Deval
- Department of Functional Pelvic Surgery & Oncology, Geoffroy Saint-Hilaire, Ramsay, Générale de Santé, Paris, France
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Shoureshi PS, Dubinskaya A, Magner D, Eilber KS. Robotic Sacrohysteropexy With Concurrent Rectopexy using Fascia Lata Graft. Urology 2023; 173:228. [PMID: 36577453 DOI: 10.1016/j.urology.2022.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 12/15/2022] [Indexed: 12/26/2022]
Abstract
INTRODUCTION AND OBJECTIVE There is limited data regarding the use of mesh for pelvic organ prolapse (POP) repair in young women of childbearing age who wish to preserve their uterus.1 Sacrohysteropexy with concurrent rectopexy can be performed in this population with a biologic graft, to decrease the risk of contamination with colorectal surgery and allow for future pregnancy.2-4 The objective of this video is to present the surgical management of prolapse repair in a young woman with uterine and rectosigmoid prolapse, causing rectal outlet obstruction. MATERIALS AND METHODS Our patient is a 21-year-old woman with over a decade of severe constipation. Her past medical history includes anxiety, depression and sexual abuse. She previously underwent robotic rectopexy for intra-rectal intussusception and mucosal prolapse with immediate improvement in her symptoms; however, two months after rectopexy, she suffered from persistent abdominal pain and severe difficulty passing stool. Dynamic resonance imaging demonstrated descent of the bladder with significant uterine prolapse, causing impingement of rectum and rectocele, blocking the evacuation of stool. The patient was thus indicated for concurrent sacrohysteropexy and rectopexy. RESULTS She underwent a robotic procedure. Given her age, in an effort to preserve future child-bearing potential, we performed the surgery with a biologic graft made of fascia lata. For the sacrohysteropexy, the graft was sutured to the posterior cervix. Intraoperatively she was noted to have an intact enterocele repair and posterior rectopexy from her previous surgery; however, there was an angulation at the recto sigmoid. This was corrected by performing a rectopexy to the fascia lata graft. She discharged home the day of surgery without incident. CONCLUSION Biologic grafts can be used for multi compartment prolapse repair in women of child-bearing age. Fascia lata provides a safe alternative to mesh to allow for future pregnancy. Also, sacrohysteropexy with concurrent rectopexy can be performed with same day discharge.
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Affiliation(s)
- Poone S Shoureshi
- Department of Urology and Colorectal Surgery, Cedars-Sinai Medical Center, Los Angeles, CA.
| | - Alexandra Dubinskaya
- Department of Urology and Colorectal Surgery, Cedars-Sinai Medical Center, Los Angeles, CA
| | - David Magner
- Department of Urology and Colorectal Surgery, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Karyn S Eilber
- Department of Urology and Colorectal Surgery, Cedars-Sinai Medical Center, Los Angeles, CA
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Impact of laparoscopic sacrocolpopexy (LSC) on sexual function in women with advanced stages of pelvic organ prolapse (POP): A five-year prospective study. Eur J Obstet Gynecol Reprod Biol 2023; 284:12-15. [PMID: 36907055 DOI: 10.1016/j.ejogrb.2023.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 02/18/2023] [Accepted: 02/22/2023] [Indexed: 02/27/2023]
Abstract
OBJECTIVE To compare patients undergoing laparoscopic sacrocolpopexy (LSC) for pelvic organ prolapse (POP), in terms of sexual function and surgical anatomical outcomes more than 5-years follow up period. STUDY DESIGN This is a cohort study of prospectively collected data that includes all women who underwent LSC between July 2005 and December 2021 at a tertiary care center. A total of 228 women were enrolled in this study. Patients completed a validated quality of life questionnaires and were evaluated using the POP-Q, the PFDI-20, PFIQ-7 and the PISQ-12 scores. Patients were divided preoperatively if they are sexually active or not and postoperatively according to the sexual improvement after POP surgery. RESULTS There was a statistically significant improvement in the PFDI, PFIQ and POPQ score. There was no significant improvement in the PISQ-12 score with more than 5 years follow-up. 76.1 % of patients who were not sexually active preoperatively resumed their sexual activity after the surgery. CONCLUSION The anatomical correction of a pelvic organ prolapse and pelvic floor disorders by laparoscopic sacrocolpopexy allowed a significant proportion (over ¾) of the women to resume sexual activity whom had not previously been sexually active. However, PISQ 12 scores did not alter significantly in those who were sexually active prior to surgery. Sexual function is a very complex issue affected by multitude of factors among which prolapse seems to be less important.
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Rusavy Z, Grinstein E, Gluck O, Abdelkhalek Y, Deval B. Long-term development of surgical outcome of laparoscopic sacrohysteropexy with anterior and posterior mesh extension. Int Urogynecol J 2023; 34:191-200. [PMID: 35416498 DOI: 10.1007/s00192-022-05102-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 01/14/2022] [Indexed: 01/14/2023]
Abstract
INTRODUCTION AND HYPOTHESIS Long-term durability and functional outcome of laparoscopic sacrohysteropexy (LSH) remains to be confirmed. We set out to assess the development of surgical outcome in women with increasing minimal follow-up. METHODS All women after LSH with anterior and posterior mesh extension operated for advanced apical uterine prolapse at Geoffroy Saint-Hilaire clinic from July 2005 to June 2020 were enrolled in this retrospective study. Last known follow-up information was used for the analysis and allocation into groups. The surgical success was defined as no prolapse beyond hymen, no symptomatic recurrence or no retreatment. Functional outcome was evaluated from validated questionnaires and presence of pelvic floor disorders. The outcomes were compared with preoperative state using chi-square and Fisher's test; p < 0.05 was considered significant. RESULTS In total, 270 patients after LSH with a follow-up of up to 14.5 years were enrolled and divided into groups according to their last follow-up length: ≥ 1 year 242, ≥ 3 years 112, ≥ 5 years 76, ≥ 7 years 45 and ≥ 10 years 18 women. Increase of minimal follow-up was associated with gradual decrease in surgical success. Rates of stress urinary incontinence were unchanged by the surgery, while anal incontinence and constipation rates decreased significantly; 14.5% of women were operated on for SUI in the follow-up. The PFDI-20, PFIQ-7 and VAS bother scores decreased significantly regardless of minimal follow-up length. CONCLUSIONS LSH with anterior and posterior mesh extension is a safe, effective and durable surgery with a positive long-term effect on quality of life. Although the surgical success gradually decreases, LSH remains a surgical success in most women.
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Affiliation(s)
- Zdenek Rusavy
- Department of Obstetrics and Gynaecology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic.
- Department of Functional Pelvic Surgery & Oncology, Geoffroy Saint-Hilaire, Ramsay, Générale de Santé, Paris, France.
| | - Ehud Grinstein
- Department of Functional Pelvic Surgery & Oncology, Geoffroy Saint-Hilaire, Ramsay, Générale de Santé, Paris, France
- Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, Israel, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ohad Gluck
- Department of Functional Pelvic Surgery & Oncology, Geoffroy Saint-Hilaire, Ramsay, Générale de Santé, Paris, France
- Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, Israel, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yara Abdelkhalek
- Department of Functional Pelvic Surgery & Oncology, Geoffroy Saint-Hilaire, Ramsay, Générale de Santé, Paris, France
| | - Bruno Deval
- Department of Functional Pelvic Surgery & Oncology, Geoffroy Saint-Hilaire, Ramsay, Générale de Santé, Paris, France
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Najib B, Feghali I, Deval B. Laparoscopic pectopexy (LP) for recurrent pelvic organ prolapse after laparoscopic sacrocolpopexy (LSC). J Minim Invasive Gynecol 2022; 29:922-923. [PMID: 35460880 DOI: 10.1016/j.jmig.2022.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 04/10/2022] [Accepted: 04/14/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Bernard Najib
- Department of Obstetrics and Gynecology. Hôtel-Dieu de France, University Hospital, St Joseph University, Beirut, Lebanon; Department of Functional Pelvic Surgery & Oncology, Geoffroy Saint-Hilaire, Ramsay Santé, Paris, France.
| | - Iman Feghali
- Department of Obstetrics and Gynecology. Hôtel-Dieu de France, University Hospital, St Joseph University, Beirut, Lebanon; Department of Functional Pelvic Surgery & Oncology, Geoffroy Saint-Hilaire, Ramsay Santé, Paris, France
| | - Bruno Deval
- Department of Functional Pelvic Surgery & Oncology, Geoffroy Saint-Hilaire, Ramsay Santé, Paris, France
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Gluck O, Rusavy Z, Grinstein E, Abdelkhalek Y, Deval B. Effect of Age on Complications Rate and Surgical Outcomes in Women Undergoing Laparoscopic Sacrohysteropexy and Sacrocolpopexy. J Minim Invasive Gynecol 2022; 29:753-758. [PMID: 35123043 DOI: 10.1016/j.jmig.2022.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/14/2022] [Accepted: 01/23/2022] [Indexed: 11/15/2022]
Abstract
STUDY OBJECTIVE To compare perioperative and long-term outcomes of laparoscopic sacrohysteropexy/sacrocolpopexy in different groups of age. DESIGN This was a retrospective cohort study. Patients were evaluated preoperatively and postoperatively (starting from 1 month after surgery, and then annually). SETTING The department of functional pelvic surgery & oncology a tertiary care center. PATIENTS All patients who underwent laparoscopic sacrohysteropexy/sacrocolpopexy, between July 2005 and December 2019 INTERVENTIONS: laparoscopic sacrohysteropexy/sacrocolpopexy. MEASUREMENTS AND MAIN RESULTS The study population was divided into three groups, according to age at time of surgery: group 1- < 65, group 2- between 65-75, and group 3- > 75. The primary outcome was the rate of perioperative complications. The secondary outcome was the comparison of long-term results between the groups. Three hundred and thirty patients were included: 183 in group 1 (mean age 53.4±8.2), 92 patients in group 2 (mean age 69.2±2.9), and 55 patients in group 3 (mean age 79.3±.5). The overall perioperative complications rate (up to 30 days after surgery) was 5.7%. No differences between the groups in operative details and rates of perioperative complications were observed. During follow up period, 37 patients (11.2%) presented with prolapse recurrence (objective and/or subjective), the rates of prolapse recurrence, as well as long-term complications, were similar between the groups. Similarly, the groups did not differ in postoperative functional results except for postoperative stress urinary incontinence. A surgery for stress urinary incontinence was more common among patients in group 3 (group 1- 13.4%, group 2- 11.9%, group 3- 31.3%, p=.008). CONCLUSION Laparoscopic sacrohysteropexy/sacrocolpopexy is associated with low rates of perioperative and long- term complications. We did not find a difference in rates of complications and/ or long-term outcomes, between different age groups.
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Affiliation(s)
- Ohad Gluck
- Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, Israel, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Functional Pelvic Surgery & Oncology, Geoffroy Saint-Hilaire, Ramsay Santé, Paris, France.
| | - Zdenek Rusavy
- Department of Obstetrics and Gynaecology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic; Department of Functional Pelvic Surgery & Oncology, Geoffroy Saint-Hilaire, Ramsay Santé, Paris, France
| | - Ehud Grinstein
- Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, Israel, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Functional Pelvic Surgery & Oncology, Geoffroy Saint-Hilaire, Ramsay Santé, Paris, France
| | - Yara Abdelkhalek
- Department of Obstetrics and Gynaecology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic; Department of Functional Pelvic Surgery & Oncology, Geoffroy Saint-Hilaire, Ramsay Santé, Paris, France
| | - Bruno Deval
- Department of Functional Pelvic Surgery & Oncology, Geoffroy Saint-Hilaire, Ramsay Santé, Paris, France
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