Skip to main content

Advertisement

SpringerLink
Log in

Complications and reoperations after laparoscopic sacrocolpopexy with a mean follow-up of 4 years

  • Original Article
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

Abstract

Introduction and hypothesis

There is a lack of knowledge concerning long-term reoperation and complications after laparoscopic sacrocolpopexy (LSCP). We analyzed the rates and indications and potential risk factors for reoperation after LSCP in a large series of consecutive patients.

Methods

This was a single-center, retrospective study including all patients who underwent LSCP between 2003 and 2013. Data regarding pelvic organ prolapse (POP), surgical modalities and perioperative complications were collected. Patients were then contacted by telephone or postal letter in 2014. The main outcome criteria were grade III Dindo classification complications: reoperation for POP recurrence, mesh complications, and urinary incontinence (UI).

Results

Between January 2003 and December 2013, a total of 464 consecutive patients (mean age, 59 years) underwent LSCP. Almost all (99.1 %) patients presented with POP ≥ grade 3 (POP-Q classification). Long-term evaluations were completed for 391 (84.1 %) patients. The median follow-up was 53.5 ± 28.2 months. The global reoperation rate was 12.5 %. The main reoperation indications were UI-related surgery in 21 patients (5.5 %), POP recurrence surgery in 20 patients (5.1 %), and mesh-related surgery in 11 patients (2.8 %). Multivariate analysis showed that older age at the time of initial surgery and concomitant subtotal hysterectomy were significant protective factors against global reoperation (HR = 0.606, CI 95 % [0.451–0.815] and 0.367, CI 95 % [0.193–0.698] respectively) and reduced the risk of POP recurrence surgery.

Conclusion

Prolapse recurrence and mesh-related surgery occurred in 5.1 and 2.8 % of patients respectively, 4 years after laparoscopic sacrocolpopexy. Age and concomitant subtotal hysterectomy could play a role in the incidence of long-term reoperation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Abbreviations

POP:

Pelvic organs prolapse

POP-QS:

Pelvic organs prolapse quantification system

LSCP:

Laparoscopic sacrocolpopexy

UI:

Urinary incontinence

GR:

Global reoperation

PRR:

Prolapse recurrence reoperation

References

  1. Bacle J, Papatsoris AG, Bigot P, Azzouzi A-R, Brychaet P-E, Piussan J, et al. Laparoscopic promontofixation for pelvic organ prolapse: a 10-year single center experience in a series of 501 patients. Int J Urol. 2011;18(12):821–6.

    Article  PubMed  Google Scholar 

  2. Claerhout F, De Ridder D, Roovers JP, Rommens H, Spelzini F, Vandenbroucke V, et al. Medium-term anatomic and functional results of laparoscopic sacrocolpopexy beyond the learning curve. Eur Urol. 2009;55(6):1459–67.

    Article  PubMed  Google Scholar 

  3. Maher CF, Feiner B, DeCuyper EM, Nichlos CJ, Hickey KV, O’Rourke P. Laparoscopic sacral colpopexy versus total vaginal mesh for vaginal vault prolapse: a randomized trial. Am J Obstet Gynecol. 2011;204(4):360.e1–7.

    Article  Google Scholar 

  4. Rozet F, Mandron E, Arroyo C, Andrews H, Cathelineau X, Mombet A, et al. Laparoscopic sacral colpopexy approach for genito-urinary prolapse: experience with 363 cases. Eur Urol. 2005;47(2):230–6.

    Article  PubMed  Google Scholar 

  5. Ross JW, Preston M. Laparoscopic sacrocolpopexy for severe vaginal vault prolapse: five-year outcome. J Minim Invasive Gynecol. 2005;12(3):221–6.

    Article  PubMed  Google Scholar 

  6. Higgs PJ, Chua H-L, Smith ARB. Long term review of laparoscopic sacrocolpopexy. BJOG. 2005;112(8):1134–8.

    Article  CAS  PubMed  Google Scholar 

  7. Sabbagh R, Mandron E, Piussan J, Brychaert PE, Tu LM. Long-term anatomical and functional results of laparoscopic promontofixation for pelvic organ prolapse. BJU Int. 2010;106(6):861–6.

    Article  PubMed  Google Scholar 

  8. Wattiez A, Canis M, Mage G, Pouly JL, Bruhat MA. Promontofixation for the treatment of prolapse. Urol Clin North Am. 2001;28(1):151–7.

    Article  CAS  PubMed  Google Scholar 

  9. Cosson M, Rajabally R, Bogaert E, Querleu D, Crepin G. Laparoscopic sacrocolpopexy, hysterectomy, and Burch colposuspension: feasibility and short-term complications of 77 procedures. JSLS. 2002;6(2):115–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  10. Coolen AL, van Oudheusden AM, van Eijndhoven HW, van der Heijden TP, Stokmans RA, Mol BW, et al. A comparison of complications between open abdominal sacrocolpopexy and laparoscopic sacrocolpopexy for the treatment of vault prolapse. Obstet Gynecol Int. 2013;2013:528636.

    PubMed  PubMed Central  Google Scholar 

  11. Claerhout F, Verguts J, Werbrouck E, Veldman J, Lewi P, Deprest J. Analysis of the learning process for laparoscopic sacrocolpopexy: identification of challenging steps. Int Urogynecol J. 2014;25(9):1185–91.

    Article  PubMed  Google Scholar 

  12. Paraiso MFR, Walters MD, Rackley RR, Melek S, Hugney C. Laparoscopic and abdominal sacral colpopexies: a comparative cohort study. Am J Obstet Gynecol. 2005;192(5):1752–8.

    Article  PubMed  Google Scholar 

  13. Rivoire C, Botchorishvili R, Canis M, Jardon K, Rabischong B, Wattiez A, et al. Complete laparoscopic treatment of genital prolapse with meshes including vaginal promontofixation and anterior repair: a series of 138 patients. J Minim Invasive Gynecol. 2007;14(6):712–8.

    Article  PubMed  Google Scholar 

  14. Unger CA, Paraiso MFR, Jelovsek JE, Barber MD, Ridgeway B. Perioperative adverse events after minimally invasive abdominal sacrocolpopexy. Am J Obstet Gynecol. 2014;211(5):547.e1–8.

    Article  Google Scholar 

  15. Deprest J, De Ridder D, Roovers J-P, Werbrouck E, Coremans G, Claerhout F. Medium term outcome of laparoscopic sacrocolpopexy with xenografts compared to synthetic grafts. J Urol. 2009;182(5):2362–8.

    Article  PubMed  Google Scholar 

  16. Sergent F, Resch B, Loisel C, Bisson V, Schaal J-P, Marpeau L. Mid-term outcome of laparoscopic sacrocolpopexy with anterior and posterior polyester mesh for treatment of genito-urinary prolapse. Eur J Obstet Gynecol Reprod Biol. 2011;156(2):217–22.

    Article  PubMed  Google Scholar 

  17. Maher C, Feiner B, Baessler K, Schmid C. Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev. 2013;4:CD004014.

    Google Scholar 

  18. North CE, Ali-Ross NS, Smith ARB, Reid FM. A prospective study of laparoscopic sacrocolpopexy for the management of pelvic organ prolapse. BJOG Int J Obstet Gynaecol. 2009;116(9):1251–7.

    Article  CAS  Google Scholar 

  19. Price N, Slack A, Jackson SR. Laparoscopic sacrocolpopexy: an observational study of functional and anatomical outcomes. Int Urogynecol J. 2011;22(1):77–82.

    Article  PubMed  Google Scholar 

  20. Granese R, Candiani M, Perino A, Romano F, Cucinella G. Laparoscopic sacrocolpopexy in the treatment of vaginal vault prolapse: 8 years experience. Eur J Obstet Gynecol Reprod Biol. 2009;146(2):227–31.

    Article  CAS  PubMed  Google Scholar 

  21. Paraiso MFR, Jelovsek JE, Frick A, Chen CCG, Barber MD. Laparoscopic compared with robotic sacrocolpopexy for vaginal prolapse: a randomized controlled trial. Obstet Gynecol. 2011;118(5):1005–13.

    Article  PubMed  Google Scholar 

  22. Deng T, Liao B, Luo D, Shen H, Wang K. Risk factors for mesh erosion after female pelvic floor reconstructive surgery: a systematic review and meta-analysis. BJU Int. 2015;117(2):323–43.

    Article  PubMed  Google Scholar 

  23. Cundiff GW, Varner E, Visco AG, Zyczynski HM, Nager CW, Norton PA, et al. Risk factors for mesh/suture erosion following sacral colpopexy. Am J Obstet Gynecol. 2008;199(6):688.e1–5.

    Article  Google Scholar 

  24. Tan-Kim J, Menefee SA, Luber KM, Nager CW, Lukacz ES. Prevalence and risk factors for mesh erosion after laparoscopic-assisted sacrocolpopexy. Int Urogynecol J. 2011;22(2):205–12.

    Article  PubMed  Google Scholar 

  25. Stepanian AA, Miklos JR, Moore RD, Mattox TF. Risk of mesh extrusion and other mesh-related complications after laparoscopic sacral colpopexy with or without concurrent laparoscopic-assisted vaginal hysterectomy: experience of 402 patients. J Minim Invasive Gynecol. 2008;15(2):188–96.

    Article  PubMed  Google Scholar 

  26. Vergeldt TFM, Weemhoff M, IntHout J, Kluivers KB. Risk factors for pelvic organ prolapse and its recurrence: a systematic review. Int Urogynecol J. 2015;26(11):1559–73.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Campeau L, Gorbachinsky I, Badlani GH, Andersson KE. Pelvic floor disorders: linking genetic risk factors to biochemical changes. BJU Int. 2011;108(8):1240–7.

    Article  CAS  PubMed  Google Scholar 

  28. Rubod C, Lecomte-Grosbras P, Brieu M, Giraudet G, Betrouni N, Cosson M. 3D simulation of pelvic system numerical simulation for a better understanding of the contribution of the uterine ligaments. Int Urogynecol J. 2013;24(12):2093–8.

    Article  Google Scholar 

  29. Pan K, Cao L, Ryan NA, Wang Y, Xu H. Laparoscopic sacral hysteropexy versus laparoscopic sacrocolpopexy with hysterectomy for pelvic organ prolapse. Int Urogynecol J. 2016;27(1):93–101.

    Article  PubMed  Google Scholar 

Download references

Authors’ contributions

D. Vandendriessche: project development, data collection, manuscript writing; J. Sussfeld: data collection; G. Giraudet: project development, manuscript editing; J-P Lucot: project development, manuscript editing; H. Béhal: data analysis, manuscript editing; M. Cosson: project development, manuscript editing.

Author information

Authors and Affiliations

  1. Gynecological Surgery Unit, Jeanne de Flandre Hospital, University Hospital of Lille, Lille, France

    David Vandendriessche, Julie Sussfeld, Géraldine Giraudet, Jean-Philippe Lucot & Michel Cosson

  2. Methodology and Biostatistics Unit, EA2694, UDSL2, University Lille Nord de France, University Hospital of Lille, Lille, France

    Hélène Behal

Authors
  1. David Vandendriessche
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Julie Sussfeld
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Géraldine Giraudet
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jean-Philippe Lucot
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hélène Behal
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Michel Cosson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to David Vandendriessche.

Ethics declarations

Conflicts of interest

Prof M. Cosson reports participation in a company-sponsored speaker’s bureau and receipt of honoraria from Olympus, Boston Scientific, and Allergan. Dr G. Giraudet performs educational activities for American Medical Systems, Astora, Boston Scientific, and Olympus. Dr J.-P. Lucot performs educational activities for Boston Scientific. D. Vandendriessche, J. Sussfeld, and H. Béhal report that they have no conflicts of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Vandendriessche, D., Sussfeld, J., Giraudet, G. et al. Complications and reoperations after laparoscopic sacrocolpopexy with a mean follow-up of 4 years. Int Urogynecol J 28, 231–239 (2017). https://doi.org/10.1007/s00192-016-3093-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00192-016-3093-6

Keywords

Search

Navigation