Surgical management of recurrent upper vaginal prolapse following sacral colpopexy

Haya, Nir, Maher, Malachy and Ballard, Emma (2015) Surgical management of recurrent upper vaginal prolapse following sacral colpopexy. International Urogynecology Journal and Pelvic Floor Dysfunction, 26 8: 1243-1245. doi:10.1007/s00192-015-2633-9


Author Haya, Nir
Maher, Malachy
Ballard, Emma
Title Surgical management of recurrent upper vaginal prolapse following sacral colpopexy
Journal name International Urogynecology Journal and Pelvic Floor Dysfunction   Check publisher's open access policy
ISSN 1433-3023
0937-3462
Publication date 2015-02-19
Year available 2015
Sub-type Article (original research)
DOI 10.1007/s00192-015-2633-9
Open Access Status
Volume 26
Issue 8
Start page 1243
End page 1245
Total pages 3
Place of publication London, United Kingdom
Publisher Springer U K
Collection year 2016
Language eng
Formatted abstract
Introduction and hypothesis
As sacral colpopexy (SC) is increasingly utilised in the surgical management of apical prolapse, we will undoubtedly be asked to manage recurrent prolapse after SC. We present a four-step technique of performing a repeated laparoscopic sacral colpopexy (LSC) for the surgical management of recurrent upper vaginal prolapse after SC surgery.

Methods
Between July 2012 and July 2013 women presenting with symptomatic post-SC vault prolapse were prospectively evaluated. Peri-operative morbidity and short-term complications were recorded. Surgical outcomes were objectively assessed utilising the Pelvic Organ Prolapse Quantification (POP-Q) system, the Australian Pelvic Floor Questionnaire (APFQ) and the Patient Global Impression of Improvement (PGI-I).

Results
Five women underwent LSC. Extensive adhesiolysis was required in three patients and the dissection was characterised by marked fibrosis. The mesh remained attached to the sacrum and had limited contact with the anterior vagina and vault in all cases. At a mean follow-up of 8.5 months all women had resolution of the awareness of prolapse, less than stage 2 prolapse on examination and high levels of satisfaction on PGI-I.

Conclusions
While the repeat LSC is feasible, safe and effective, adhesions and marked fibrosis make this a challenging intervention. Further evaluation is required.
Keyword Laparoscopic sacral colpopexy
Apical prolapse
Mesh
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Non HERDC
School of Medicine Publications
 
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