E-Posters-Laparoscopic Uterosacral Ligament Colpopexy at the Time of Hysterectomy: 3-year Prognosis

Laparoscopic Uterosacral Ligament Colpopexy at the Time of Hysterectomy: 3-year Prognosis - Kazauki Yoshimura, Prof.

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This study evaluated the perioperative complications and anatomical outcomes of laparoscopic uterosacral ligament (USL) colpopexy, a surgical procedure for pelvic organ prolapse (POP). A total of 129 cases underwent the procedure from 2013 to 2016, with a 3-year follow-up on 90 cases. The study found that laparoscopic USL colpopexy provided advantages over the transvaginal approach, such as avoiding organ, nerve, and ureteral injuries, and achieving secure culdeplasty. It was also effective for cases of uterine prolapse and/or contraindication of mesh usage. However, the recurrence rate of severe cystocele and/or complete prolapse after laparoscopic USL colpopexy was high.<br /><br />The mean age, operative time, and amount of hemorrhage were recorded. Overall, recurrent prolapse (POP-Q stage II or higher) was noted in 29 patients. Among the 51 patients with preoperative POP-Q stage II uterine prolapse alone, only 2 patients presented recurrent rectocele, resulting in a recurrence rate of 3.9%. The pre/postoperative average POP-Q scores at Ba point (bladder), C point (vaginal cuff), and Bp point (rectum) showed significant improvement.<br /><br />Comparisons with previous studies showed that laparoscopic USL colpopexy had similar or better outcomes in terms of recurrence rates and complication rates compared to transvaginal USL colpopexy. The study concluded that laparoscopic visualization of uterosacral ligaments is a safe procedure and a useful native tissue repair option for apical support in patients with POP. The study also included data on recurrent sites and rates for different types of POP, as well as intraoperative complications.<br /><br />Overall, this study provides evidence that laparoscopic USL colpopexy is a viable surgical option for the treatment of uterine prolapse, with good anatomical outcomes and lower complication rates compared to transvaginal approaches.

Keywords

laparoscopic USL colpopexy

perioperative complications

anatomical outcomes

pelvic organ prolapse

transvaginal approach

recurrence rate

severe cystocele

complete prolapse

native tissue repair

lower complication rates