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Collin-Bund V, Viviani V, Meyer N, Goetsch T, Boisramé T, Faller E, Lecointre L, Gabriele V, Akladios C, Garbin O, Host A. Study of the feasibility of outpatient sacrocolpopexy by laparoscopy. J Gynecol Obstet Hum Reprod 2024; 53:102792. [PMID: 38663686 DOI: 10.1016/j.jogoh.2024.102792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 03/18/2024] [Accepted: 04/22/2024] [Indexed: 05/05/2024]
Abstract
INTRODUCTION Laparoscopic sacrocolpopexy (LSCP) is currently the gold standard surgical technique for treating pelvic prolapse. This study aimed to evaluate the feasibility of laparoscopic sacrocolpopexy in ambulatory care. PATIENTS AND METHODS This prospective study was conducted to evaluate the feasibility of LSCP in women who visited the outpatient department of obstetrics and gynecology at the University Hospital of Strasbourg between July 2018 and December 2021. All women with indications for laparoscopic sacrocolpopexy for prolapse treatment who were willing to be treated as outpatients were included. The main criterion of the study was to evaluate the rate of re-hospitalization between discharge from the outpatient department after LSCP and postoperative follow-up consultations. RESULTS Among the whole population (57/200, 28.5 %) included, 4 (7 %) were hospitalized. The quality of life was not altered with a preserved EuroQol (EQ-5D) quality of life score with a mean score of 73±18.4 standard deviation (SD) 95 % confidence interval (CI) (67.9; 78.1) on postoperative day 3 (D3) and 91.2 ± 16.3 SD 95 % CI (86.2-96) on D30. On D1, D2, D3, and D7, the anxiety rate evaluated by State-Trait Anxiety Inventory score (STAI Y-A) remained low, with mean scores of 24.8 ± 9.6 SD 95 % [23.4-26.5] on D30. All patients were satisfied or very satisfied with the procedure and outpatient management, with an average score of 9.6/10 (range: 8-10). CONCLUSION This prospective, monocentric study evaluating the feasibility of outpatient LSCP reported demonstrated low rates of complications and re-hospitalization after outpatient management. Furthermore, the patients' quality of life was not altered, and they patients were satisfied with this type of management.
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Affiliation(s)
- V Collin-Bund
- Department of Gynecologic Surgery, Strasbourg University Hospital, Strasbourg, France; Laboratoire d'ImmunoRhumatologie Moléculaire, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR_S 1109, Institut thématique interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Faculté de Médecine, Fédération Hospitalo-Universitaire OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France.
| | - V Viviani
- Department of Gynecologic Surgery, Strasbourg University Hospital, Strasbourg, France
| | - N Meyer
- Department of Public Health, Biostatistic laboratory, Université de Strasbourg, 67081 Strasbourg, France
| | - T Goetsch
- Department of Public Health, Biostatistic laboratory, Université de Strasbourg, 67081 Strasbourg, France
| | - T Boisramé
- Department of Gynecologic Surgery, Strasbourg University Hospital, Strasbourg, France
| | - E Faller
- Department of Gynecologic Surgery, Strasbourg University Hospital, Strasbourg, France
| | - L Lecointre
- Department of Gynecologic Surgery, Strasbourg University Hospital, Strasbourg, France; I-Cube UMR 7357-Laboratoire des Sciences de L'ingénieur, de L'informatique et de L'imagerie, Université de Strasbourg, 67081 Strasbourg, France; Institut Hospitalo-Universitaire (IHU), Institute for Minimally Invasive Hybrid Image-Guided Surgery, Université de Strasbourg, 67081 Strasbourg, France
| | - V Gabriele
- Department of Gynecologic Surgery, Strasbourg University Hospital, Strasbourg, France
| | - C Akladios
- Department of Gynecologic Surgery, Strasbourg University Hospital, Strasbourg, France
| | - O Garbin
- Department of Gynecologic Surgery, Strasbourg University Hospital, Strasbourg, France
| | - A Host
- Department of Gynecologic Surgery, Strasbourg University Hospital, Strasbourg, France
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Serbetcioglu GC, Simsek SY, Alemdaroglu S, Aytac PC, Kalayci H, Celik H. Outcomes of nerve-sparing laparoscopic sacropexy on one hundred fifteen cases. J Gynecol Obstet Hum Reprod 2020; 49:101795. [PMID: 32474191 DOI: 10.1016/j.jogoh.2020.101795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 04/24/2020] [Accepted: 04/26/2020] [Indexed: 11/21/2022]
Abstract
STUDY OBJECTIVE To evaluate the postoperative anatomic and functional outcomes of patients who underwent laparoscopic nerve-sparing sacrocolpopexy or sacrocervicopexy for pelvic organ prolapse (POP) POP-Q stage III and IV apical prolapse, and to delineate the contributing factors for recurrence. STUDY DESIGN AND CLASSIFICATION The file records of patients who underwent sacropexy in the last five years were reviewed retrospectively and compared in terms of preoperative and postoperative anatomic findings and symptoms. PATIENTS Patients who underwent laparoscopic nerve-sparing surgery for treatment of POP-Q Stage III and IV/prolapse of uterine or vaginal cuff were included. INTERVENTIONS Postoperative anatomic and functional outcomes were evaluated using POP-Q classification and urinary/anal function by questioning during visits. RESULTS The mean follow-up duration was 24.2 ± 17.6 months. Anatomic recovery was achieved in 104 (90.4 %) cases. Advanced age (≥70 years), longer duration of symptoms, and low body mass index were determined as parameters related to recurrence risk.
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Abstract
The aim of the study is to evaluate anatomic and functional late-term outcomes of robotic mesh sacrocolpopexy (RMS) at a single tertiary-care institution. Following IRB approval, a retrospective chart review of a prospectively collected database on consecutive patients who underwent RMS for symptomatic pelvic organ prolapse and had 3 year minimum follow-up was performed. Data collected included physical examination, validated questionnaires including Urogenital Distress Inventory, Incontinence Impact Questionnaire, and global Quality of Life (QOL). The primary outcome was failure defined as the need for re-operation and/or prolapse recurrence by examination. Those with office follow-up < 36 months underwent structured phone interviews. Between 12/2007 and 2/2012, 56 women underwent RMS. Thirty women had follow-up ≥ 3 years (median 64 (IQR 48-85) months). Mean C-point went from - 2.33 (range 0 to - 5) to - 9.00 (0 to - 12) (p < 0.01), and mean QOL score from 3.93 (0-10) to 1.93 (0-8) (p < 0.01). Two developed recurrent vault prolapse later on at 26 and 34 months, respectively. Four women (13%) required surgery for secondary prolapses, with three for anterior compartment and one for posterior compartment. Sixteen of twenty six were contacted via structured phone interviews, with 14 doing well, one deceased, and one who underwent a secondary posterior compartment prolapse 6 years later at an outside facility. This long-term study indicates durability for RMS in the management of symptomatic pelvic organ prolapse.
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Affiliation(s)
- Karen Jong
- UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9110, USA
| | - Ted Klein
- UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9110, USA
| | - Philippe E Zimmern
- UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9110, USA.
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Alhalabi F, Bacsu CD, Gulpinar O, Scott DJ, Zimmern PE. Are women with advanced pelvic organ prolapse treated by open mesh sacrocolpopexy at risk of secondary incisional hernia? Int Urogynecol J 2015; 26:1673-7. [PMID: 26082193 DOI: 10.1007/s00192-015-2758-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 06/01/2015] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Our purpose was to determine whether vaginal hernia is a predisposing factor for incisional hernia (IH) in a cohort of women with symptomatic pelvic organ prolapse (POP) who underwent corrective repair by open mesh sacrocolpopexy (MSC) and had long-term follow-up to determine their rate of subsequent IH. METHODS Following IRB approval, the charts of women entered into a longitudinal database and who underwent open MSC at a tertiary institution were reviewed. Data collected included demographics, MSC and IH details, and long-term outcome. Patients were excluded if the follow-up after MSC was < 1 year. Data were reviewed by a neutral investigator who was not involved in patient care (FA). RESULTS From 1999 to 2012, 75 of 88 women met inclusion criteria, with mean follow-up of 65 (48-84) months. Thirteen were either lost to follow-up or had follow-up < 1 year. Seven women underwent symptomatic IH repair, with a mean onset of IH diagnosis after MSC at 18 (range 8-72) months. Five repairs were done via an open approach, and two were repaired laparoscopically. No IH recurrence was noted at a mean of 41 (range 14-75) months after IH repair. No risk factors were identified in the IH group compared with those who did not form a secondary IH. CONCLUSIONS In this longitudinal series, IH after open MSC occurred in 9.3%, a rate comparable with that reported in women undergoing abdominal procedures through midline or Pfannenstiel incisions.
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Affiliation(s)
- Feras Alhalabi
- Department of Urology, UT Southwestern Medical Center, Dallas, TX, USA
| | - Chasta D Bacsu
- Department of Urology, UT Southwestern Medical Center, Dallas, TX, USA
| | - Omer Gulpinar
- Department of Urology, UT Southwestern Medical Center, Dallas, TX, USA
| | - Daniel J Scott
- Department of Surgery, UT Southwestern Medical Center, Dallas, TX, USA
| | - Philippe E Zimmern
- Department of Urology, UT Southwestern Medical Center, Dallas, TX, USA. .,UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9110, USA.
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Turgut A, Soydinç HE, Evsen MS, Başaranoğlu S, Yalınkaya A. Which parameters may influence the duration of hospitalization after vaginal hysterectomy? J Turk Ger Gynecol Assoc 2013; 14:15-8. [PMID: 24592064 DOI: 10.5152/jtgga.2013.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Accepted: 02/08/2013] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To estimate the variables that may affect the duration of hospitalization after vaginal hysterectomy. MATERIAL AND METHODS An 11-year retrospective analysis was performed on data derived from 197 patients who underwent vaginal hysterectomy due to non-malignant pathology at a tertiary care center between January 2000 to November 2011. RESULTS The average age of the patients in our series was 60.9±11.1 with a duration of hospitalization of 11.6±6.1 days after vaginal hysterectomy. The grouping variables consisted of age, number of pregnancies, abortions, parities and the presence of intra or postoperative complications. Advanced age (>60), increased number of pregnancies (>5) and parities (>5) and occurrence of intra or postoperative complications were found to be correlated with the duration of hospitalization after vaginal hysterectomy. Categorical variables were analyzed by Pearson's chi square or the Fisher exact test. The Mann Whitney U test was used to compare groups, while the correlation of variables was assessed with the Spearman Correlation Analysis. CONCLUSION Vaginal hysterectomy is a safe and effective procedure. Advanced age, increased number of pregnancies and parities and occurrence of intra or postoperative complications may prolong the duration of hospitalization after surgery. Increased experience, careful surgical technique and adherence to aseptic principles may improve the cost-effectivity and decrease the duration of hospitalization.
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Affiliation(s)
- Abdulkadir Turgut
- Department of Obstetrics and Gynaecology, School of Medicine, Dicle University, Diyarbakır, Turkey
| | - Hatice Ender Soydinç
- Department of Obstetrics and Gynaecology, School of Medicine, Dicle University, Diyarbakır, Turkey
| | - Mehmet Sıddık Evsen
- Department of Obstetrics and Gynaecology, School of Medicine, Dicle University, Diyarbakır, Turkey
| | - Serdar Başaranoğlu
- Department of Obstetrics and Gynaecology, School of Medicine, Dicle University, Diyarbakır, Turkey
| | - Ahmet Yalınkaya
- Department of Obstetrics and Gynaecology, School of Medicine, Dicle University, Diyarbakır, Turkey
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