<abstract xmlns="http://www.w3.org/1999/xhtml"><p> Advanced utero-vaginal prolapse is a frequent condition in the aging female population and several strategies aimed at its treatment have been developed. In order to demonstrate the importance of using the vaginal route in assistance to laparoscopic hysterosacropexy, a retrospective case series was designed, comparing thirty-two patients diagnosed with stage III-IV uterovaginal prolapse according to the POP-Q system. The patients were treated between 2006-2011 using one of two methods of hysterosacropexy: vaginally assisted laparoscopic hysterosacropexy (VALHS) in 18 cases and total laparoscopic hysterosacropexy (LHS) in 14 cases. The choice of method was based on the primary mechanism of central compartment prolapse. The total operative time, the time required for mesh fixation at the cervix and sacrum, the cure rate of prolapse and the rate of re-operation for prolapse were statistically analyzed for both LHS and VALHS and compared between these two procedures by Student T-Test. The main outcome parameters were related to the operative method. The total operative time proved to be equal for both procedures, although the time necessary to attach the mesh to the cervical ring was shorter in VALHS. Therefore, the combination of the vaginal and laparoscopic routes yields a minimally invasive variant of sacropexy with as short an operative time as possible. The vaginal route offers a safe alternative for suturing the mesh and treating concurrent vaginal wall prolapse, while laparoscopy reduces the inherent risks of open abdominal surgery. </p></abstract>

Advanced utero-vaginal prolapse is a frequent condition in the aging female population and several strategies aimed at its treatment have been developed. In order to demonstrate the importance of using the vaginal route in assistance to laparoscopic hysterosacropexy, a retrospective case series was designed, comparing thirty-two patients diagnosed with stage III-IV uterovaginal prolapse according to the POP-Q system. The patients were treated between 2006-2011 using one of two methods of hysterosacropexy: vaginally assisted laparoscopic hysterosacropexy (VALHS) in 18 cases and total laparoscopic hysterosacropexy (LHS) in 14 cases. The choice of method was based on the primary mechanism of central compartment prolapse. The total operative time, the time required for mesh fixation at the cervix and sacrum, the cure rate of prolapse and the rate of re-operation for prolapse were statistically analyzed for both LHS and VALHS and compared between these two procedures by Student T-Test. The main outcome parameters were related to the operative method. The total operative time proved to be equal for both procedures, although the time necessary to attach the mesh to the cervical ring was shorter in VALHS. Therefore, the combination of the vaginal and laparoscopic routes yields a minimally invasive variant of sacropexy with as short an operative time as possible. The vaginal route offers a safe alternative for suturing the mesh and treating concurrent vaginal wall prolapse, while laparoscopy reduces the inherent risks of open abdominal surgery.

Vaginally-Assisted Laparoscopic Hysterosacropexy for Advanced Utero-Vaginal Prolapse: A Series of 32 Cases

“Saint Pantelimon” Clinical Emergency Hospital, Department of Obstetrics and Gynecology, Bucharest, Romania; “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania

“Euroclinic” Hospital, Department of Obstetrics and Gynecology, Bucharest, Romania; “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania

“Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania

ARS Medica Tomitana

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Advanced utero-vaginal prolapse is a frequent condition in the aging female population and several strategies aimed at its treatment have been developed. In...

Vaginally-Assisted Laparoscopic Hysterosacropexy for Advanced Utero-Vaginal Prolapse: A Series of 32 Cases

Published Online: Sep 09, 2014

Page range: 63 - 70

DOI: https://doi.org/10.2478/arsm-2014-0012

Keywords
hysterosacropexy, utero-vaginal prolapse, vaginal assistance

© by P.C. Brătilă

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Vaginally-Assisted Laparoscopic Hysterosacropexy for Advanced Utero-Vaginal Prolapse: A Series of 32 Cases

Published Online: Sep 09, 2014

Page range: 63 - 70

DOI: https://doi.org/10.2478/arsm-2014-0012

Keywordshysterosacropexy, utero-vaginal prolapse, vaginal assistance

© by P.C. Brătilă

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Keywords
hysterosacropexy, utero-vaginal prolapse, vaginal assistance