title: Uterus-preserving laparoscopic lateral suspension with mesh for pelvic organ prolapse: a patient-centred outcome report and video of a continuous series of 245 patients.
abstract: OBJECTIVE
  Changes in the psychological value of reproductive organs have led to a growing interest in uterine-preserving surgery for pelvic organ prolapse (POP). Sacral hysteropexy is considered as gold standard, although dissection of the promontory may be challenging. We show a video and present a report on a series of patients operated by laparoscopic lateral suspension with mesh as an alternative.
  
  
  METHODS
  Clinical evaluation was performed using the simplified Pelvic Organ Prolapse Quantification System (POP-Q). Primary outcomes were subjective and objective cure; secondary outcomes were rates for reoperation and complications. We assessed patient's satisfaction in a telephone interview using a visual analogue scale and the Patient Global Impression of Improvement Scale (PGI-I) scale.
  
  
  RESULTS
  Two hundred and fifty-four patients were treated between 2004 and 2011 with a median follow-up of 7.5 years. At 1 year 82.7 % of patients were asymptomatic, and anatomic success rates were 88.2 % for the anterior, 86.1 % for the apical and 80.8 % for the posterior compartment; 1.2 % had mesh exposure, and the reoperation rate was 7.4 %. More than 80 % of patients were highly satisfied with the outcome.
  
  
  CONCLUSIONS
  Uterine-preserving laparoscopic lateral suspension with mesh is a safe technique with promising results and low complication rates. It may be an alternative to sacral hysteropexy for high-morbidity patients.
authors.affiliation: Faculty of Medicine, University of Geneva, Geneva, Switzerland. nikolaus.veitrubin@gmail.com.
authors.forename: Nikolaus
authors.initials: N
authors.lastname: Veit-Rubin
authors.affiliation: Faculty of Medicine, University of Geneva, Geneva, Switzerland.
authors.forename: Jean-Bernard
authors.initials: JB
authors.lastname: Dubuisson
authors.affiliation: Department of Obstetrics and Gynaecology, University Hospitals Geneva, Geneva, Switzerland.
authors.forename: Sören
authors.initials: S
authors.lastname: Lange
authors.affiliation: Department of Obstetrics and Gynaecology, University Hospitals Geneva, Geneva, Switzerland.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Eperon
authors.affiliation: Department of Obstetrics and Gynaecology, University Hospitals Geneva, Geneva, Switzerland.
authors.forename: Jean
authors.initials: J
authors.lastname: Dubuisson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D059351:Organ Sparing Treatments / Q000379:methods*; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011446:Prospective Studies; D013526:Surgical Mesh; D016896:Treatment Outcome
keywords: Laparoscopic lateral suspension; Patient satisfaction; Pelvic organ prolapse