title: Laparoscopic promontofixation for pelvic organ prolapse: a 10-year single center experience in a series of 501 patients.
abstract: OBJECTIVE
  To assess the long-term outcomes of laparoscopic promontofixation (LP) for the treatment of pelvic organ prolapse (POP).
  
  
  METHODS
  A total of 501 consecutive patients with POP were included in this prospective study. The patients' mean age was 63.23 (36-90) years, their mean body mass index was 25.14 (15-36) and their mean number of deliveries was 3.3 (0-14). A POP grade ≥3 was diagnosed in 70.4% of the patients and 38.9% of them had a history of abdominal surgery. The patients underwent a Bonney test and urodynamic study. In cases of stress urinary incontinence (SUI), the patients underwent the simultaneous insertion of a tension-free vaginal tape. A prolapse quality of life questionnaire was sent to all patients.
  
  
  RESULTS
  The mean operative time was 97.4 min (50-210) and there were 1.7% cases of intra-operative complications. The mean hospitalization time was 3.7 days (1-13 days). During the mean follow-up of 20.7 months (3-120), 91 (17.8%) complications were recorded, including constipation (5.5%), SUI (3.5%), vaginal erosion (2.4%), and urge incontinence (2%). Recurrences were recorded in 11.5% of the patients within an average time of 37.2 months. Risk factors for recurrence were the use of the polypropylene mesh compared with the polyester mesh (P<0.0001), an intra-operative hysterectomy (P=0.02), and bleeding (P=0.049). There was a statistical significant (P<0.001) improvement in most of the symptoms in the prolapse quality of life questionnaire.
  
  
  CONCLUSIONS
  LP is safe with effective long-term results, with low recurrence and morbidity rates, and a good quality of life.
authors.affiliation: Department of Urology, Clinique Chirurgicale du Pré, Le Mans, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Bacle
authors.forename: Athanasios G
authors.initials: AG
authors.lastname: Papatsoris
authors.forename: Pierre
authors.initials: P
authors.lastname: Bigot
authors.forename: Abdel-Rahmene
authors.initials: AR
authors.lastname: Azzouzi
authors.forename: Pierre-Emmanuel
authors.initials: PE
authors.lastname: Brychaet
authors.forename: Jean
authors.initials: J
authors.lastname: Piussan
authors.forename: Eric
authors.initials: E
authors.lastname: Mandron
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003248:Constipation / Q000209:etiology; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000150:complications / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology*; D011446:Prospective Studies; D011788:Quality of Life; D012008:Recurrence; D012307:Risk Factors; D053825:Suburethral Slings; D013997:Time Factors; D014550:Urinary Incontinence, Stress / Q000150:complications / Q000601:surgery; D053202:Urinary Incontinence, Urge / Q000209:etiology; D014563:Urodynamics; D014623:Vaginal Diseases / Q000209:etiology