title: Safety and one year outcomes following vaginally assisted laparoscopic uterine sacropexy (VALUES) for advanced uterine prolapse.
abstract: OBJECTIVE
  To assess the safety and outcomes of vaginally assisted laparoscopic uterine sacropexy (VALUES) as a surgical treatment for stage 3 and 4 uterine prolapse.
  
  
  METHODS
  Seventy consecutive women with stage 3 and 4 uterine prolapse who underwent VALUES over 2-year period were prospectively evaluated. Women filled the Prolapse Quality of Life Questionnaire (P-QOL), and underwent examination using pelvic organ prolapse quantification system (POP-Q) pre- and post-operatively. In addition, patients filled the patient global impression of improvement questionnaire post-operatively. Mesh related complications were evaluated post-operatively. Patients were followed up at 3 and 12 months following surgery. This study reports the 12 months outcomes.
  
  
  RESULTS
  Sixty-four women (91.4%) reported cure of their prolapse symptoms. On examination, 67 women (95.7%) had POP-Q stage 0 or 1 uterine support at 12 months. Six women needed further surgical intervention for prolapse (8.5%); three women developed recurrent uterine prolapse and three other women developed symptomatic recurrent anterior vaginal wall prolapse. The total vaginal length was not different between the pre- and post-operative periods. Two patients developed mesh related complications. Significant improvement was noted in prolapse symptoms and quality of life.
  
  
  CONCLUSIONS
  VALUES is a safe and effective treatment for women with stage 3 and 4 uterine prolapse up to 12 months without the risk of vaginal shortening. Long-term results are needed to fully establish the value of this technique.
authors.affiliation: Department of Obstetrics and Gynecology, Luton and Dunstable University Hospital NHS Foundation Trust, Luton, United Kingdom.
authors.forename: Abdalla M
authors.initials: AM
authors.lastname: Fayyad
authors.forename: Chrysostomos S
authors.initials: CS
authors.lastname: Siozos
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000295:instrumentation; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012008:Recurrence; D012074:Remission Induction; D012086:Reoperation; D013526:Surgical Mesh; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014596:Uterine Prolapse / Q000175:diagnosis / Q000601:surgery*; D055815:Young Adult
keywords: laparoscopy; sacrohysteropexy; uterine prolapse