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Open Access 01-04-2019 | Original Article

Uterus preservation is superior to hysterectomy when performing laparoscopic lateral suspension with mesh

Authors: Nikolaus Veit-Rubin, Jean Dubuisson, Florin Constantin, Sören Lange, Isabelle Eperon, Victor Gomel, Jean-Bernard Dubuisson

Published in: International Urogynecology Journal | Issue 4/2019

Abstract

Introduction and hypothesis

We aimed to compare differences between laparoscopic lateral suspension with mesh (LLS) performed with supracervical hysterectomy (LLSHE) and without hysterectomy (LLSUP).

Methods

We retrospectively collected data from women operated by a single surgeon between 2003 and 2011. From a total of 339 women with symptomatic anterior and/or apical pelvic organ prolapse (POP) and an intact uterus, 224 had LLSUP (70.4%) and 94 had LLSHE (29.6%). Three hundred and sixteen patients were examined at 1 year. Primary outcomes were objective and subjective success at 1 year during clinical evaluation. Secondary outcomes were complications (Clavien-Dindo scale) and mesh exposure. Patient satisfaction was evaluated by telephone interview using a 10-point scale and the Patient Global Impression of Improvement Scale (PGI-I).

Results

LLSUP and LLSHE did not differ for age (mean 57 and 55 years, respectively), preoperative status, complications, and participation at the interview (52 vs 53%). LLSHE is associated with higher mesh exposure (6.5 vs 1.3%, p = 0.014) and more frequent use of Mersilene. Titanium-coated and noncoated polypropylene was more frequently used in LLSUP. At 1 year, both anatomic success rate for the anterior compartment (98.7 vs 94.6%, p = 0.021) and subjective success rate (83.5 vs 72.8%, p = 0.035) were higher for LLSUP. Without hysterectomy, patients more often improved (90.5 vs 76.5%, p = 0.013) and would more frequently recommend the procedure (94.5 vs 80.4%, p = 0.004).

Conclusions

LLS with or without hysterectomy is a safe technique with high patient satisfaction. The uterus-preserving approach appears to result in better anatomic outcome for the anterior compartment, better subjective outcome, and higher patient satisfaction.

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Title: Uterus preservation is superior to hysterectomy when performing laparoscopic lateral suspension with mesh
Authors: Nikolaus Veit-Rubin
Jean Dubuisson
Florin Constantin
Sören Lange
Isabelle Eperon
Victor Gomel
Jean-Bernard Dubuisson
Publication date: 01-04-2019
Publisher: Springer International Publishing
Published in: International Urogynecology Journal / Issue 4/2019
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-018-3678-3

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Uterus preservation is superior to hysterectomy when performing laparoscopic lateral suspension with mesh

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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