title: Laparoscopic sacral colpopexy approach for genito-urinary prolapse: experience with 363 cases.
abstract: 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.
authors.affiliation: Department of Urology, Institut Mutualiste Montsouris, Université René Descartes, 42 Boulevard Jourdan, 75674 Paris cedex, France. francois.rozet@imm.fr
authors.forename: Francois
authors.initials: F
authors.lastname: Rozet
authors.forename: Eric
authors.initials: E
authors.lastname: Mandron
authors.forename: Carlos
authors.initials: C
authors.lastname: Arroyo
authors.forename: Henry
authors.initials: H
authors.lastname: Andrews
authors.forename: Xavier
authors.initials: X
authors.lastname: Cathelineau
authors.forename: Annick
authors.initials: A
authors.lastname: Mombet
authors.forename: Nathalie
authors.initials: N
authors.lastname: Cathala
authors.forename: Guy
authors.initials: G
authors.lastname: Vallancien
mesh_terms: 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*
chemical_list: D001672:Biocompatible Materials; D011091:Polyesters