Laparoscopic sacrocolpopexy for uterine and post-hysterectomy prolapse: anatomical and functional outcomes.

ABSTRACT

OBJECTIVE: To evaluate the anatomical and functional outcomes following laparoscopic sacrocolpopexy in a local unit. DESIGN: Retrospective case series. SETTING: A regional hospital in Hong Kong. PATIENTS All women who underwent laparoscopic sacrocolpopexy for symptomatic uterine or post-hysterectomy prolapse from January 2003 to December 2008. MAIN OUTCOME MEASURES: Anatomical outcomes, functional outcomes including complications. RESULTS: A total of 31 patients were recruited. The success rate in treating apical vaginal wall prolapse was 100%. There were no recurrences of vault prolapse (defined as stage II or higher). Approximately 19% of women had anterior vaginal wall prolapse and 23% had urinary stress incontinence postoperatively; 6% had a second operation because of anterior vaginal wall prolapse. The rates of dyspareunia and constipation were low. The mean hospital stay was 4 (range, 2-11) days. Two patients sustained bladder injuries and one rectal injury resulting in a rectovaginal fistula. For three patients the procedure was converted to a laparotomy. CONCLUSIONS: Laparoscopic sacrocolpopexy is feasible in our population and has a high success rate for treating apical vaginal wall prolapse. The incidence of complications was acceptable.