Laparoscopic sacral colpopexy approach for genito-urinary prolapse: experience with 363 cases.
OBJECTIVE
To evaluate the surgical outcome, complications and benefits of laparoscopic double promonto-fixation for patients with pelvic prolapse.


METHODS
Women with genito-urinary prolapse underwent a transperitoneal placement of a 100% polyester mesh on the anterior vaginal wall and a posterior mesh on the levator ani muscle. Both of these were anchored to the sacral promontory. A TVT was placed simultaneously in patients who had concurrent stress urinary incontinence.


RESULTS
A total of 363 patients were operated upon between 1996 and 2002. Their mean age was 63 (range 35-78), average follow-up was 14.6 months, the mean operating time was 97 minutes. There were 8 conversions due to anesthetic or surgical difficulties. Follow up was done by a postal questionnaire and physical examination at 6 months and then yearly. 96% were satisfied with the results of their operation and no patients complained of sexual dysfunction. There was a 4% recurrence rate of prolapse, 3 vaginal erosions, 2 urinary retentions that required TVT section, 1 bowel incarcerations, 1 spondylitis and 2 mesh infection.


CONCLUSIONS
Laparoscopic promonto-fixation is feasible and highly effective technique that offers good long-term results with complication rates similar to open surgery, with the added benefits of minimally invasive surgery.
Rozet
Francois
F
Department of Urology, Institut Mutualiste Montsouris, Université René Descartes, 42 Boulevard Jourdan, 75674 Paris cedex, France. francois.rozet@imm.fr
Mandron
Eric
E
Arroyo
Carlos
C
Andrews
Henry
H
Cathelineau
Xavier
X
Mombet
Annick
A
Cathala
Nathalie
N
Vallancien
Guy
G
D000328:Adult; D000368:Aged; D001672:Biocompatible Materials / Q000627:therapeutic use; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D011091:Polyesters / Q000627:therapeutic use; D012005:Rectal Prolapse / Q000601:surgery; D012189:Retrospective Studies; D013526:Surgical Mesh; D016896:Treatment Outcome; D013519:Urogenital Surgical Procedures / Q000379:methods*; D014596:Uterine Prolapse / Q000601:surgery*
D001672:Biocompatible Materials; D011091:Polyesters