title: Early safety and efficacy outcomes of a novel technique of sacrocolpopexy for the treatment of apical prolapse.
abstract: OBJECTIVE
  To assess the safety and efficacy of a modified technique of bilateral abdominal sacrocolpopexy in which both uterosacral ligaments are replaced with polyvinylidene fluoride mesh to provide support to the cervix (cervico-sacropexy [CESA]) or vaginal vault (vagino-sacropexy [VASA]).
  
  
  METHODS
  A retrospective observational study was undertaken of women with posthysterectomy vault prolapse or recurrent apical prolapse following previous prolapse repair who underwent bilateral sacrocolpopexy between July 1, 2013, and December 31, 2014, in a tertiary referral unit in the UK. Before surgery and 3 months afterwards, prolapse was assessed using the Pelvic Organ Prolapse Quantification scale and functional outcomes were recorded using the International Consultation on Incontinence Questionnaire for vaginal symptoms and urinary incontinence.
  
  
  RESULTS
  Fifty women were included. At 3 months, 47 (94%) patients reported no bulge symptoms and the mean point C was -7.6. Complications comprised bladder injury in 1 (2%) and minor wound problems in 3 (6%) patients. No mesh erosion was reported.
  
  
  CONCLUSIONS
  Bilateral abdominal sacrocolpopexy seems to be a safe and effective option for apical prolapse. Longer-term follow-up is needed to detect prolapse recurrence and mesh-related complications.
authors: Norfolk and Norwich University Hospital, Norwich, UK. Electronic address: smita.rajshekhar@yahoo.co.uk.
authors: Smita
authors: S
authors: Rajshekhar
authors: Norfolk and Norwich University Hospital, Norwich, UK.
authors: Sambit
authors: S
authors: Mukhopadhyay
authors: Norfolk and Norwich University Hospital, Norwich, UK.
authors: Edward
authors: E
authors: Morris
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002584:Cervix Uteri / Q000601:surgery; D004739:England; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation*; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000150:complications / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D012447:Sacrum / Q000601:surgery*; D013526:Surgical Mesh / Q000706:statistics & numerical data*; D062606:Tertiary Care Centers; D001743:Urinary Bladder / Q000293:injuries; D014549:Urinary Incontinence / Q000453:epidemiology; D014621:Vagina / Q000601:surgery
keywords: Apical prolapse; Bilateral abdominal sacrocolpopexy; Cervico-sacropexy (CESA); Polyvinylidene fluoride mesh; Vagino-sacropexy (VASA)