Abstract
Different techniques have been proposed over the last decades to avoid the vaginal vault prolapse following hysterectomy for severe (stage III–IV) apical pelvic organ prolapse. In this scenario, the laparoscopic duplication of the uterosacral ligaments to the vaginal apex might represent a simple alternative procedure, associated with low morbidity and optimal surgical outcomes. In this paper, we present the preliminary results of 25 consecutive patients, who underwent total laparoscopic hysterectomy followed by uterosacral ligament duplication for stage III–IV apical pelvic organ prolapse. A detailed description of the surgical procedure is also provided.
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References
Chow D, Rodríguez LV (2013) Epidemiology and prevalence of pelvic organ prolapse. Curr Opin Urol 23:293–298. https://doi.org/10.1097/MOU.0b013e3283619ed0
Laganà AS, La Rosa VL, Rapisarda AMC, Vitale SG (2017) Pelvic organ prolapse: the impact on quality of life and psychological well-being. J Psychosom Obstet Gynecol 39:164–166. https://doi.org/10.1080/0167482X.2017.1294155
Thompson JC, Rogers RG (2016) Surgical management for pelvic organ prolapse and its impact on sexual function. Sex Med Rev 4:213–220. https://doi.org/10.1016/j.sxmr.2016.02.002
Vitale SG, La Rosa VL, Rapisarda AMC, Laganà AS (2017) Sexual life in women with stress urinary incontinence. Oman Med J 32:174–175. https://doi.org/10.5001/omj.2017.33
Haylen BT, de Ridder D, Freeman RM et al (2010) An international urogynecological association (IUGA)/international continence society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J 21:5–26. https://doi.org/10.1007/s00192-009-0976-9
Robinson D, Thiagamoorthy G, Cardozo L (2018) Post-hysterectomy vaginal vault prolapse. Maturitas 107:39–43. https://doi.org/10.1016/j.maturitas.2017.07.011
Vitale SG, Laganà AS, Noventa M et al (2018) Transvaginal bilateral sacrospinous fixation after second recurrence of vaginal vault prolapse: efficacy and impact on quality of life and sexuality. Biomed Res Int 2018:5727165. https://doi.org/10.1155/2018/5727165
Schiavi MC, Savone D, Di Mascio D et al (2018) Long-term experience of vaginal vault prolapse prevention at hysterectomy time by modified McCall culdoplasty or Shull suspension: clinical, sexual and quality of life assessment after surgical intervention. Eur J Obstet Gynecol Reprod Biol 223:113–118. https://doi.org/10.1016/j.ejogrb.2018.02.025
Coolen ALWM, Bui BN, Dietz V et al (2017) The treatment of post-hysterectomy vaginal vault prolapse: a systematic review and meta-analysis. Int Urogynecol J 28:1767–1783. https://doi.org/10.1007/s00192-017-3493-2
Serati M, Braga A, Bogani G et al (2015) Iliococcygeus fixation for the treatment of apical vaginal prolapse: efficacy and safety at 5 years of follow-up. Int Urogynecol J Pelvic Floor Dysfunct 26:1007–1012. https://doi.org/10.1007/s00192-015-2629-5
Barber MD, Brubaker L, Burgio KL et al (2014) Comparison of 2 transvaginal surgical approaches and perioperative behavioral therapy for apical vaginal prolapse: the OPTIMAL randomized trial. JAMA 311:1023–1034. https://doi.org/10.1001/jama.2014.1719
Tan-Kim J, Menefee SA, Luber KM et al (2011) Prevalence and risk factors for mesh erosion after laparoscopic-assisted sacrocolpopexy. Int Urogynecol J 22:205–212. https://doi.org/10.1007/s00192-010-1265-3
Gutman RE, Rardin CR, Sokol ER et al (2017) Vaginal and laparoscopic mesh hysteropexy for uterovaginal prolapse: a parallel cohort study. Am J Obstet Gynecol 216:38.e1–38.e11. https://doi.org/10.1016/j.ajog.2016.08.035
Rahmanou P, White B, Price N, Jackson S (2012) Laparoscopic hysteropexy: 1–4 years follow up of women post operation. Int Urogynecol J 25:131–138. https://doi.org/10.1007/s00192-012-1875-z
Food and Drug Administration, HHS (2016) Obstetrical and gynecological devices; reclassification of surgical mesh for transvaginal pelvic organ prolapse repair; final order. Fed Regist 81:353–361
Strasberg SM, Linehan DC, Hawkins WG (2009) The accordion severity grading system of surgical complications. Ann Surg 250:177–186. https://doi.org/10.1097/SLA.0b013e3181afde41
Srikrishna S, Robinson D, Cardozo L (2010) Validation of the patient global impression of improvement (PGI-I) for urogenital prolapse. Int Urogynecol J 21:523–528. https://doi.org/10.1007/s00192-009-1069-5
von Elm E, Altman DG, Egger M et al (2008) The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol 61:344–349. https://doi.org/10.1016/j.jclinepi.2007.11.008
Uccella S, Morosi C, Marconi N et al (2018) Laparoscopic versus open hysterectomy for benign disease in uteri weighing > 1 kg: a retrospective analysis on 258 patients. J Minim Invasive Gynecol 25:62–69. https://doi.org/10.1016/j.jmig.2017.07.005
Uccella S, Casarin J, Marconi N et al (2016) laparoscopic versus open hysterectomy for benign disease in women with giant uteri (≥ 1500 g): feasibility and outcomes. J Minim Invasive Gynecol 23:922–927. https://doi.org/10.1016/j.jmig.2016.05.002
Serati M, Braga A, Cantaluppi S et al (2018) Vaginal cystocele repair and hysteropexy in women with anterior and central compartment prolapse: efficacy and safety after 30 months of follow-up. Int Urogynecol J 29:831–836. https://doi.org/10.1007/s00192-017-3498-x
Vitale SG, La Rosa VL, Rapisarda AMC, Laganà AS (2017) The importance of a multidisciplinary approach or women with pelvic organ prolapse and cystocele. Oman Med J 32:263–264. https://doi.org/10.5001/omj.2017.52
Chang T-C, Hsiao S-M, Chen C-H et al (2015) clinical outcomes and urodynamic effects of tailored transvaginal mesh surgery for pelvic organ prolapse. Biomed Res Int 2015:191258. https://doi.org/10.1155/2015/191258
Vitale SG, Laganà AS, Gulino FA et al (2016) Prosthetic surgery versus native tissue repair of cystocele: literature review. Updates Surg 68:325–329. https://doi.org/10.1007/s13304-015-0343-y
Vakili B, Chesson RR, Kyle BL et al (2005) The incidence of urinary tract injury during hysterectomy: a prospective analysis based on universal cystoscopy. Am J Obstet Gynecol 192:1599–1604. https://doi.org/10.1016/j.ajog.2004.11.016
Weber AM, Walters MD, Piedmonte MR (2000) Sexual function and vaginal anatomy in women before and after surgery for pelvic organ prolapse and urinary incontinence. Am J Obstet Gynecol 182:1610–1615. https://doi.org/10.1067/mob.2000.107436
Kim-Fine S, Smith CY, Gebhart JB, Occhino JA (2014) Medium-term changes in vaginal accommodation and sexual function after vaginal reconstructive surgery. Female Pelvic Med Reconstr Surg 20:27–32. https://doi.org/10.1097/SPV.0000000000000037
Kokanalı MK, Cavkaytar S, Aksakal O, Doğanay M (2015) McCall culdoplasty vs. sacrospinous ligament fixation after vaginal hysterectomy: comparison of postoperative vaginal length and sexual function in postmenopausal women. Eur J Obstet Gynecol Reprod Biol 194:218–222. https://doi.org/10.1016/j.ejogrb.2015.09.023
Nishimura K, Yoshimura K, Hoshino K, Hachisuga T (2017) Laparoscopic fixation of the vaginal cuff to the uterosacral ligaments at the time of hysterectomy. Int Urogynecol J 28:321–323. https://doi.org/10.1007/s00192-016-3137-y
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FG performed the surgeries; BG and SC collected data; ASL and JC performed data analysis and wrote the manuscript; MS edited the manuscript. All the authors conform the International Committee of Medical Journal Editors (ICMJE) criteria for authorship, contributed to the intellectual content of the study and gave approval for the final version of the article.
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Serati, M., Laganà, A.S., Casarin, J. et al. Laparoscopic duplication of the uterosacral ligaments following hysterectomy for stage III–IV apical pelvic organ prolapse. Updates Surg 72, 199–204 (2020). https://doi.org/10.1007/s13304-019-00690-9
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DOI: https://doi.org/10.1007/s13304-019-00690-9