Laparoscopic cervicopexy for correction of apical genital prolapse in 10 steps: a pilot study
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IUJ VIDEO
Laparoscopic cervicopexy for correction of apical genital prolapse in 10 steps: a pilot study Casadio Paolo 1 & Arena Alessandro 1 & Paolo Salucci 1
&
Raimondo Diego 1 & Seracchioli Renato 1
Received: 27 May 2020 / Accepted: 8 September 2020 # The International Urogynecological Association 2020
Abstract Introduction Surgical repair of pelvic organ prolapse is one of the most frequent gynecological procedures, and its frequency is expected to increase as the population is gradually aging. Mesh use in urogynecological surgery should be limited because of important and life-treating complications. Sacral mesh-less and lateral procedures have been described as safe and effective to treat apical compartment prolapse. In this video, we describe a new laparoscopic mesh-less cervicopexy in women with symptomatic uterovaginal prolapse who did not desire uterine preservation. Methods Eleven women with symptomatic uterovaginal prolapse [stage 2 or higher according to the Pelvic Organ Prolapse Quantitative (POP-Q) classification system] underwent laparoscopic mesh-less cervicopexy to the sacrum and transverse fascia between May 2018 and June 2019. We performed application of the right uterosacral ligament starting from the sacrum and two semicontinous sutures including the transverse fascia, round ligament, prevescical peritoneum, pubocervical fascia and cervix that were subsequently knotted. Results At 6-month follow-up, the objective success rate for apical prolapse (POP-Q score C > −1) was 90.9% (10/11 women). Only one woman presented stage 3 apical prolapse recurrence with vaginal buldge. Conclusion Laparoscopic mesh-less cervicopexy for uterovaginal prolapse seems to be a feasible surgical technique at 6-month follow-up. Keywords Prolapse . Laparoscopy . Cervicopexy . Mesh-less
Introduction Surgical repair of pelvic organ prolapse is one of the most frequent gynecological procedures, and its frequency is expected to increase as the population gradually ages [1]. The goal of pelvic organ prolapse surgery is to restore the support and suspension of the pelvic organs to improve bladder, bowel and sexual function [2]. According to a Cochrane review, abdominal promontofixation represents the gold standard surgical procedure for the correction of utero-vaginal prolapse, because this Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00192-020-04536-6) contains supplementary material. This video is also available to watch on http://link.springer. com/. Please search for this article by the article title or DOI number, and on the article page click on ‘Supplementary Material’. * Paolo Salucci [email protected] 1
Gynaecology and Human Reproduction Physiopathology, DIMEC, S. Orsola Hospital, University of Bologna, Bologna, Italy
procedure is associated with a lower rate of recurrent prolapse and less incidence of dyspareunia [3]. Laparoscopic lateral suspension with mesh has been demonstrated as an efficient alternative technique to apical prolapse [4, 5]. Re
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