title: Mid-term outcome of laparoscopic sacrocolpopexy with anterior and posterior polyester mesh for treatment of genito-urinary prolapse.
abstract: OBJECTIVE
  To evaluate the anatomical and functional outcomes of laparoscopic sacrocolpopexy using an anterior and a posterior polyester mesh, for the cure of genital prolapse at one year or longer.
  
  
  METHODS
  This is a consecutive 5 year prospective observational study in which 119 patients presented with at least a Stage 2 apical prolapse, with an anterior or a posterior vaginal wall prolapse, who underwent a double sacrocolpopexy. Two large pore size (≥ 1mm) heavyweight (115 g/m(2)) multifilaments of polyester prostheses (Parietex Prosup PAC/GK 06, Sofradim-Covidien) were exclusively used for this technique. The prostheses were fixed on the levator ani muscles, the vagina and the sacrum with permanent extracorporeal laparoscopic sutures. Pre- and post-operative data referring to international pelvic organ prolapse quantitation classification (POP-Q), scores of quality of life and sexuality (French equivalent of the Pelvic Floor Distress Inventory (PFDI), Pelvic Floor Impact Questionnaire (PFIQ) and Pelvic organ prolapse-urinary Incontinence-Sexual Questionnaire (PISQ-12)) were compared.
  
  
  RESULTS
  With a mean follow-up of 34 months, 116 patients were accessible for evaluation. For these patients, the anatomical success rates (Stage 0 or 1) on the apical, anterior or posterior compartments were respectively, 97%, 89% and 98%. On the functional level, all the scores of quality of life and sexuality were improved.
  
  
  CONCLUSIONS
  This study confirms the effectiveness of laparoscopic sacrocolpopexy for the repair of the apical compartment prolapse. It also shows its effectiveness for the anterior compartment repair when the cystocele is moderate and limited to a median defect. In our experience, laparoscopic sacrocolpopexy with heavyweight polyester prosthesis is an effective treatment of the posterior defect.
authors.affiliation: Department of Obstetrics and Gynaecology, Grenoble University Hospital and University of Grenoble, B.P. 217, 38043 Grenoble Cedex 09, France. FSergent@chu-grenoble.fr
authors.forename: Fabrice
authors.initials: F
authors.lastname: Sergent
authors.forename: Benoît
authors.initials: B
authors.lastname: Resch
authors.forename: Cécile
authors.initials: C
authors.lastname: Loisel
authors.forename: Violène
authors.initials: V
authors.lastname: Bisson
authors.forename: Jean-Patrick
authors.initials: JP
authors.lastname: Schaal
authors.forename: Loïc
authors.initials: L
authors.lastname: Marpeau
mesh_terms: D000328:Adult; D000368:Aged; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011091:Polyesters; D011446:Prospective Studies; D019919:Prosthesis Implantation; D053825:Suburethral Slings; D013526:Surgical Mesh; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D011091:Polyesters