LAPAROSCOPIC SACROCOLPOPEXY VERSUSTRANSVAGINAL APPROACH USING UPHOLD MESH IN THE MANAGEMENT OF PELVICORGAN PROLAPSE
F. CHUANG1, I.ISMAEIL MOHAMED 1, L. WU 1, K. HUANG 2;
1Department of Obstetrics and Gynecology, KaohsiungChang Gung Mem. Hosp., Chang Gung Univ. Coll. of Med., Kaohsiung,Taiwan, 2Urogynecology, Kaohsiung Chang Gung Mem. Hosp.,Kaohsiung, Taiwan.
Introduction: Surgicalintervention to correct level I support of pelvic floor may beperformed with transabdominal or transvaginal approach.
Objective:To assess the postoperative outcomes of laparoscopic sacrocolpopexyand transvaginal Uphold mesh.
Methods: A total of 64patients with pelvic organ prolapse stage II-IV were included in thisretrospective cohort study after fulfilling the criteria of theresearch and acceptance of the informed consent. The patientsunderwent laparoscopic sacrocolpopexy or transvaginal pelvicreconstructive surgery with Uphold device between September 2012 andOctober 2016 were reviewed. Outcomes were measured as postoperativefollow up duration, anatomic success rate, post-operative stressurinary incontinence (SUI), mesh protrusion.
Results: GroupA included 31 patients having mean age of 53.6 years (range 42-71)who were treated by laparoscopic sacrocolpopexy/hysteropexy with meanfollow up duration of 12.5 months (range 1-36 months), whereas, 33patients in Group B with mean age of 69 years were treated usingUphold mesh as a method of choice for pelvic reconstructive surgerywith follow up mean duration of 4.6 months (range 1-12). In term ofsuccess rate, there were no statistical difference between the twogroups 96.8% V 96.9% respectively. Post-operative SUI was higherparameter in both groups 9/31 (29%), 13/33 (39%) respectively. Meshprotrusion was 5 in group A and 3 in group B.
Conclusions:Our study demonstrated that both laparoscopicsacrocolpopexy/hysteropexy and transvaginal Uphold mesh procedurehave comparable effective anatomic outcomes. The incidence ofpostoperative SUI was higher in group of transvaginal Upholdmesh.