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abstract

415 - SURGICAL RESULTS OF LAPAROSCOPIC SACRAL VAGINAL FUSION SURGERY FOR PELVIC ORGAN PROLAPSE

415

SURGICAL RESULTS OF LAPAROSCOPICSACRAL VAGINAL FUSION SURGERY FOR PELVIC ORGAN PROLAPSE

T. SHINO;
UrogynecologyCenter, Kamda Med. Ctr., Chiba, Japan.

Introduction: Since the US Foodand Drug Administration issued warnings regarding the use of vaginalmesh surgery, different approaches in the management of pelvic organprolapse[POP] are considered.
Objective: Laparoscopicsacrocolpopexy [LSC] in particular,has been considered a betteralternative in management of POP because of its advantage such asless bleeding during surgery,minimal post-operative pain,smallersurgical scar,good healing process and faster return to normalactivity.Since 2013 wa at Kameda Medical Center and KitakyushuGeneral Hospital have performed more than 600 cases of LSC assurgical management for POP .This study aims to review theintraoperative post-operative complications as well as recurrencerate after LSC.
Methods: This study included 605 patientswho underwent LSC for POP at Kameda Medical Center and KitakyusyuGeneral Hospital fron 2013 to 2016..The average age of the targetpatients was 64.6 years, average parity was 2.3 times and averagebody mass index[BMI] is 23.5 kg/m2LSC was done byperforming supracervical hysterectomy with double mesh placement tosupport the anterior and posterior vaginal wall. Data involvingintraoperative and post-operative complications as well as recurrencerate were reviewed retrospectively.
Results: Recurrence ofPOP-Q stage II and higher was observed in 37 cases (6.1%).POP stageII relapse involved 29 cases (4.8%) while 8 cases (1.3%) had POPstage III.Three cases (0.5%) required reoperation all of which werePOP stage III. All three cases who underwent reoperationpredominantly involved the anterior wall and placement of anteriormesh were done.Intraoperative complications noted were 4 bladderinjuries, 1 rectal injury, 2 bowel injuries and 2 vaginal wallinjuries.In about 1 month after surgery, 1 case of ileus due tointernal hernia was noted and laparotomy was necessary. Three casesof ileus were confirmed and were managed conservatively.
Conclusions:LSC with anterior and posterior mesh placement seems to be aneffective management of POP with excellent long-Term outcome andbenefits. However, it can also have serious complications.Accuratediagnosis and follow-up before and after surgery isnecessary.
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