title: Laparoscopic uterosacral ligament suspension and sacral colpopexy: results and complications.
abstract: OBJECTIVE
  We describe our techniques, outcomes, and complications with laparoscopic procedures for correcting pelvic organ prolapse (POP). We hypothesized that laparoscopic abdominal sacrocolpopexy (ASC) gives better anatomic results than laparoscopic uterosacral ligament suspension (USLS), without increased complications.
  
  
  METHODS
  This was a retrospective cohort study of 290 patients who underwent laparoscopic suspensions in a 2-year period. Anatomic measurements using the Pelvic Organ Prolapse Quantification (POP-Q) system were collected. Subjective data were obtained from the Pelvic Floor Distress Inventory Short-Form 20 (PFDI) questionnaire. The anatomic improvement for each stage and complication rates were analyzed. The difference in the risk of mesh erosion between patients undergoing concomitant total hysterectomy and those who had a prior hysterectomy was determined. In 102 patients with stage 2 prolapse, a comparison between ASC and USLS in anatomic and subjective results and complication rates was performed.
  
  
  RESULTS
  Anatomic success rates ranged between 86 % and 95 %. Overall mesh erosion rate was 1.2 %, showing no difference between concomitant total laparoscopic hysterectomy (0 %) and prior hysterectomy (2.1 %, p = 0.155). ASC resulted in statistically significantly better anterior-compartment support than USLS (p = 0.043). There was no difference in apex or posterior compartment position or in PFDI scores.
  
  
  CONCLUSIONS
  Laparoscopic ASC may be better than USLS for correcting anterior-compartment prolapse, with only a minor risk of mesh erosion.
authors.affiliation: Women's Pelvic Health and Continence Center, Houston, TX, USA, GFilmar@gmail.com.
authors.forename: Gilad A
authors.initials: GA
authors.lastname: Filmar
authors.forename: Hilaire W
authors.initials: HW
authors.lastname: Fisher
authors.forename: Enrique
authors.initials: E
authors.lastname: Aranda
authors.forename: Peter M
authors.initials: PM
authors.lastname: Lotze
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003127:Colposcopy / Q000379:methods*; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D007044:Hysterectomy; D010535:Laparoscopy / Q000379:methods*; D008022:Ligaments / Q000601:surgery*; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D012445:Sacrococcygeal Region / Q000601:surgery*; D013526:Surgical Mesh / Q000009:adverse effects; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014599:Uterus / Q000601:surgery*