Satisfaction, quality of life and lumbar pain following laparoscopic sacrocolpopexy: suture vs. tackers.
OBJECTIVE
To compare the operative results and rate of complications, in particular dorsolumbar pain, following laparoscopic sacrocolpopexy (LS) using sutures or tackers.


METHODS
A case-control study: LS using tackers (n=35, tacker group) compared with LS using sutures (n=65, suture group). In addition to clinical evaluation of prolapse, all patients were evaluated for urinary incontinence (ICIQ-SF), dorsolumbar pain, overall quality of life (SF-36 score), and overall improvement in symptoms (PGI-I), one year after LS.


RESULTS
The patient characteristics (age, initial stage of prolapse,…) were comparable in the two groups, as was operating time (240 vs. 210min, p=0.18). There was no significant between-group difference in terms of anatomical correction (median post-operative ICS stage: 0 in both groups, p=0.26) or post-operative complication rates. The incidence of de novo low back pain appearing after LS was equivalent in both groups (50% vs. 25%, in the tacker and suture groups, respectively, p=0.11). However, there was a significant difference in lumbar pain intensity evaluated using the visual analog scale (4 (IQR 0-6.5) vs. 0 (IQR 0-4) in the tacker and suture groups, respectively; p=0.01), and in post-operative quality of life, which was better in patients in the suture group according to all the questionnaires.


CONCLUSIONS
Our study suggests that the use of tackers for prosthesis fixation to the promontory does not increase the incidence of post-operative dorsolumbar pain, but may increase its intensity and decrease quality of life.
AP-HP, Service de Gynécologie-Obstétrique et Médecine de la Reproduction, Hôpital Antoine Béclère, Clamart 92141, France.
Sarah
S
Vieillefosse
AP-HP, Service de Gynécologie-Obstétrique et Médecine de la Reproduction, Hôpital Antoine Béclère, Clamart 92141, France.
Thibault
T
Thubert
Clinique urologique, hôpital Bichat, AP-HP, 75018 Paris, France.
Arnaud
A
Dache
Clinique urologique, hôpital Bichat, AP-HP, 75018 Paris, France.
Jean-François
JF
Hermieu
AP-HP, Service de Gynécologie-Obstétrique et Médecine de la Reproduction, Hôpital Antoine Béclère, Clamart 92141, France. Electronic address: xavier.deffieux@abc.aphp.fr.
Xavier
X
Deffieux
D016022:Case-Control Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D017116:Low Back Pain / Q000453:epidemiology*; D008875:Middle Aged; D017060:Patient Satisfaction; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013536:Suture Techniques
Dorsolumbar pain; Genital prolapse; Pelvic organ prolapse; Sacral colpopexy; Sacrocolpopexy; Tacker