Modified laparoscopic sacrocolpopexy with mesh for severe pelvic organ prolapse

OBJECTIVE: To evaluate anatomic and sexual outcomes among patients with severe pelvic organ prolapse, defined as stage III or higher by Pelvic Organ Prolapse Quantification (POP-Q), who underwent modified laparoscopic sacrocolpopexy.

METHODS: Between March 2007 and December 2010, a prospective study in Beijing, China, enrolled 21 patients who underwent vaginal hysterectomy, followed by modified laparoscopic sacrocolpopexy with the attachment of mesh straps transvaginally and the sacral attachment of mesh laparoscopically. Patients were assessed at 6 weeks, 6 months, and yearly. Anatomic success was defined as POP-Q lower than stage II. Sexual outcomes were assessed via the short-form Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12).

RESULTS: During a median follow-up of 43.5 months (range 18-60 months), the surgical success rate was 100%, the patient satisfaction rate was 90.4%, and 1 patient (4.8%) experienced mesh exposure. Postoperatively, 20 patients were sexually active (95.2%). There was a significant improvement between pre- and postoperative PISQ-12 scores both for the total score (31.6 vs 38.5; P<0.001), and for 5 individual items (P<0.01).

CONCLUSION: Modified laparoscopic sacrocolpopexy with mesh seemed to be safe and might simplify the surgical approach to severe POP with satisfying anatomic and functional outcomes. It did not affect sexual function negatively.