Long-term follow-up of laparoscopic sacrocolpopexy: comparison of two different techniques used in urology and gynecology.

ABSTRACT

INTRODUCTION AND HYPOTHESIS: Numerous studies have found that the short-term results of laparoscopic sacrocolpopexy for pelvic organ prolapse are safe and effective. This study evaluates the long-term results of the laparoscopic sacrocolpopexy operation between the urology and gynecology branches. METHODS: A prospective study enrolling 206 patients was conducted to evaluate laparoscopic sacrocolpopexy as a surgical treatment for vaginal vault prolapse from 2011 to 2014. Two different surgical branches (urology and gynecology) applied laparoscopic sacrocolpopexy to their patients with their own techniques. The long-term results were assessed postoperatively after 4 years by pelvic examinations, including the Pelvic Organ Prolapse Quantification system (POP-Q) and quality-of-life assessments using validated questionnaires. RESULTS: A total of 190 patients (94 urology and 96 gynecology patients) received a full clinical follow-up examination between April 2014-June 2018. Postoperative pelvic organ prolapse recurrence rates in each compartment were similar in both groups during the 4 years; 87.2% of the urology and 86.5% of the gynecology patients had no prolapse in any compartment according to the POP-Q system. The reoperation rate was 5.3% for the urology and 6.2% for the gynecology group. Mesh erosion was detected in two patients in both groups. Three patients responded to local estrogen therapy, and we removed the mesh vaginally in one patient. The subjective cure rate was 89.4% in the urology and 88.5% in the gynecology group after 4 years. CONCLUSIONS: Although different surgical branches perform laparoscopic sacrocolpopexy with their own techniques, long-term anatomical and functional results are similar between the branches. From a urogynecological point of view, laparoscopic sacrocolpopexy is a gold standard surgical procedure that can be performed by both urologists and gynecologists with similar long-term outcomes.