Efficacy of vaginal and laparoscopic sacrocolpopexy (VLSCP), a dual approach to utero-vaginal prolapse, compared with laparoscopic sacrocolpopexy (LSCP) alone

• Published in: Pelviperineology Vol. 35; no. 4; p. 113
• Main Authors: Aharoni, Ariel, Mamet, Yaakov, Agranat, Abraham
• Format: Journal Article
• Language: English; Italian
• Published: Padua Galenos Publishing House 01.12.2016
• Subjects: Laparoscopy; Vagina
• ISSN: 1973-4905; 1973-4913

Sacrocolpopexy is one of the most successful operations for correcting utero-vaginal prolapse. It can be done laparoscopically, but this is time-consuming and requires experienced laparoscopists. In 2011, we introduced a dual vaginal-laparoscopic technique (VLSCP), which combined the ease of vaginal suturing with the advantages of laparoscopic sacrocolpopexy (LSCP). We, now, evaluate the efficacy of this dual approach in comparison to the primary laparoscopic operation. We compared the efficacy and short-term results of 61 patients who had the dual operation to that of 28 classical LSCP patients. The study was retrospective and included analysis of patients’ records.We examined 11 of the 28 LSCP patients (39%), 3-7 years after the operation, and 35 of the 61 VLSCP patients (57%), 1-5 years after the operation. The short-term results of the dual operation showed that it was faster, without compromising the wellbeing of the patients. The long-term results for the available patients showed that the subjective cure rate was 73% for the LSCP patients and 88% for the VLSCP dual operation. However, we observed some degree of vaginal prolapse in 82% of the LSCP operations, mainly cystocele or rectocele grade 1 or 2, but only 31% of the VLSCP patients had such prolapse. There were no mesh erosions or exposures in any of the groups. The dual operation combined the ease and accuracy of a vaginal operation with the benefits to the patient from a laparoscopic approach. It also enabled a convenient approach to add vaginal procedures that improved the surgical results, or complied with the patients’ wishes.