Outcome and assessment of QOL in patients underogoing laparoscopic sacrocolpopexy
IUGA Academy. Okazoe H. Jun 30, 2018; 212817; 532 Topic: Pelvic Organ Prolapse
Homare Okazoe
Homare Okazoe

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Outcome and assessment of QOL in patients underogoing laparoscopic sacrocolpopexy

Okazoe, H1; Ito, A1; Hirama, H1

1: KKR takamatsu hospital

Introduction: In Japan, laparoscopic sacrocolpopexy (LSC) is the new procedure for women with pelvic organ prolapse (POP) and approved by national medical insurance in April 2016. In addition to tension-free vaginal mesh (TVM) surgery, we introduced LSC for POP patients from August 2016 in our hospital.

Objective: The aim of this study was short term outcome and assessment of QOL in patients undergoing laparoscopic sacrocolpopexy.

Methods: The cohort of this study was 50 patients underwent LSC in the period between August 2016 and January 2018. We compared QOL before and after surgery using P-QOL (prolapse quality of life questionnaire) in patients with POP. Regarding QOL survey, 41 patients evaluated at 1 months after LSC, 24 patients evaluated at 6 months after LSC and 9 patients evaluated at 12 months after LSC were examined. The surgical procedure of LSC was performed with double mesh method (Japanese style LSC) in which the vaginal anterior and posterior walls were peeled as far as possible to the periphery and the mesh was left indwelling, in all cases except one case of recurrence after TVM surgery. Patients characteristics: The median age was 67 years old (54-82 years old), the median BMI was 24.8 (20.1-34.0), the type of POP was 21 cases of cystocele, rectocele and uterine prolapse, 16 cases of cystocele and uterine prolapse, 3 cases of cystocele, 2 cases of uterine prolapse, 2 cases of rectocele, and 6 cases of vaginal prolapse after total hysterectomy. The severity of POP was 8 cases in Grade 2, 39 cases in Grade 3 and 3 cases in Grade 4

Results: The median operating time was 306 minutes (175-440 minutes) and amount of bleeding was 8.2 ml (0-150 ml). Postoperative complications were one case of adhesion ileus and two cases of port site infection, both of which were conservatively improved. One patient showed recurrence of cystocele at 3 months after LSC, but it dealt with self-care ring pessary. A comparison of QOL before and after LSC revealed significant improvement in domains of general health, role limitations, physical/social limitations, emotions, and sleep /energy in 1 months after LSC. At the 6 and 12 months after LSC, all domains were significantly improved compared to before operation.

Conclusions: Although LSC tends to have longer operation time than conventional surgery, it is thought that LSC was lower complications and recurrence rate and has a higher QOL improvement and it is useful as a treatment option presented to patients with POP.


Work supported by industry: no.

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