Laparoscopic promontofixation for pelvic organ prolapse: A 10-year single center experience in a series of 501 patients

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Abstract

Objectives:

To assess the long-term outcomes of laparoscopic promontofixation (LP) for the treatment of pelvic organ prolapse (POP).

Methods:

A total of 501 consecutive patients with POP were included in this prospective study. The patients' mean age was 63.23 (36–90) years, their mean body mass index was 25.14 (15–36) and their mean number of deliveries was 3.3 (0–14). A POP grade ≥3 was diagnosed in 70.4% of the patients and 38.9% of them had a history of abdominal surgery. The patients underwent a Bonney test and urodynamic study. In cases of stress urinary incontinence (SUI), the patients underwent the simultaneous insertion of a tension-free vaginal tape. A prolapse quality of life questionnaire was sent to all patients.

Results:

The mean operative time was 97.4 min (50–210) and there were 1.7% cases of intra-operative complications. The mean hospitalization time was 3.7 days (1–13 days). During the mean follow-up of 20.7 months (3–120), 91 (17.8%) complications were recorded, including constipation (5.5%), SUI (3.5%), vaginal erosion (2.4%), and urge incontinence (2%). Recurrences were recorded in 11.5% of the patients within an average time of 37.2 months. Risk factors for recurrence were the use of the polypropylene mesh compared with the polyester mesh (P < 0.0001), an intra-operative hysterectomy (P = 0.02), and bleeding (P = 0.049). There was a statistical significant (P < 0.001) improvement in most of the symptoms in the prolapse quality of life questionnaire.

Conclusions:

LP is safe with effective long-term results, with low recurrence and morbidity rates, and a good quality of life.

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