OBJECTIVE: The aim of this prospective study was to assess the safety and effectiveness of a new single laparoscopic operation devised to relieve obstructed defecation, gynecologic and urinary symptoms in a large series of female patients with multiorgan pelvic prolapse. METHODS: We submitted 384 female patients to laparoscopic pelvic organ prolapse suspension operation, a new technique based on suspension of the middle pelvic compartment, by using a polypropylene mesh and followed up 368 of them, with defecography performed 12 months after surgery and a standardized protocol. RESULTS: The 368 patients were followed-up for 36.3 (±4.4) months, Recurrence rate was 4.9% for obstructed defecation syndrome and 3.3% for stress urinary incontinence. Complication rate was 2.9%. The mean period of daily activity resumption was 16.3 days (±4.8 days). Anorectal and urogynecologic symptoms and scores significantly improved after the operation (P < 0.001), with no worsening of anal continence. Incidence of postoperative fecal urgency was 0%. Postoperative defecography showed a significant (P < 0.001) improvement of all parameters in 315 patients (82%). Short Form 36 Health Survey score significantly improved after the operation (P < 0.01). An excellent/good overall Satisfaction Index was reported by 78.0% of patients. CONCLUSIONS: In our experience the Laparoscopic-Pelvic Organ Prolapse Suspension seems to be safe and effective as a 1-stage treatment of associated pelvic floor diseases. Randomized studies with an appropriate control group and longer follow-up are now needed to assess the effectiveness of this promising technique.
A Minimally Invasive Technique for the 1-Stage Treatment of Complex Pelvic Floor Diseases: Laparoscopic-Pelvic Organ Prolapse Suspension / P. Boccasanta, M. Venturi, S. Agradi, C. Vergani, G. Calabrò, C. Missaglia, L. Bordoni, A. Longo. - In: FEMALE PELVIC MEDICINE & RECONSTRUCTIVE SURGERY. - ISSN 2151-8378. - 27:1(2021), pp. 28-33.
|Titolo:||A Minimally Invasive Technique for the 1-Stage Treatment of Complex Pelvic Floor Diseases: Laparoscopic-Pelvic Organ Prolapse Suspension|
|Parole Chiave:||pelvic organ prolapse; rectal prolapse; laparoscopy; stress urinary incontinence; rectocele|
|Settore Scientifico Disciplinare:||Settore MED/18 - Chirurgia Generale|
Settore MED/12 - Gastroenterologia
Settore MED/24 - Urologia
Settore MED/40 - Ginecologia e Ostetricia
|Data di pubblicazione:||2021|
|Data ahead of print / Data di stampa:||3-apr-2019|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1097/SPV.0000000000000722|
|Appare nelle tipologie:||01 - Articolo su periodico|