Analysis of the Clinical Value of Laparoscopic Sacrocolpopexy to Support the Posterior Compartment in Women with Multicompartment Prolapse Including Rectocele
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Surgical Technique
2.3. Statistical Analysis
3. Results
3.1. Objective Outcome Measurements
3.2. Subjective Outcome Measurements
3.3. Subgroup Analysis
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Demographics | n = 112 | POP-Stage, Posterior Compartment | n = 112 |
---|---|---|---|
Age (years), mean ± standard deviation | 61 ± 10 | stage II (n/%) | 97/87% |
Parity, median (lower quartile/upper quartile) | 2 (2/3) | stage III (n/%) | 15/13% |
Birth weight (g), mean ± standard deviation | 3702 ± 566 | Type of performed surgery | |
Obesity (BMI > 30 kg/m2) (n/%) | 15/13% | Laparoscopic sacrocolpopexy (n/%) | 34/30% |
Previous pelvic organ prolapse surgery | Lap. supracervical hysterectomy plus SCP (n/%) | 53/47% | |
Anterior colporrhaphy (n/%) | 12/11% | Lap. assisted vaginal hysterectomy plus SCP (n/%) | 16/14% |
Posterior colporrhaphy (n/%) | 3/3% | Laparoscopic total hysterectomy plus SCP (n/%) | 3/3% |
Rectopexy (n/%) | 1/1% | Vaginal hysterectomy plus SCP (n/%) | 3/3% |
Sacrospinous fixation, Mc Call (n/%) | 5/4% | Laparoscopic sacrohysteropexy (n/%) | 3/3% |
Sacrocolpopexy (n/%) | 1/1% | Concomitant PR (n/%) | 11/10% |
Sacrohysteropexy (n/%) | 1/1% |
POP-Q Values | Preoperative * | Postoperative * | p-Value |
---|---|---|---|
n = 112 | n = 106 | ||
Aa | 0 (−1/2) | −3 (−3/−2) | <0.001 |
Ba | 1 (0/2) | −3 (−3/−2) | <0.001 |
C/D | −1 (−2/0) | −8 (−10/−7) | <0.001 |
Ap | −1 (−1/0) | −3 (−3/−2.75) | <0.001 |
Bp | 0 (−1/0) | −3 (−3/−2) | <0.001 |
TVL | 10 (8/10) | 10 (9/11) | 0.0002 |
gh | 4 (3/4) | 4 (3/4) | 0.0015 |
pb | 3 (2/3) | 3 (3/3) | 0.7 |
Preoperative * | Postoperative ° | p-Value | |||||||
---|---|---|---|---|---|---|---|---|---|
Never | Occasionally | Frequently | Daily | Never | Occasionally | Frequently | Daily | ||
straining to empty | 24/21% | 57/51% | 19/17% | 12/11% | 36/35% | 53/51% | 11/11% | 3/3% | <0.001 |
laxative use | 99/88% | 8/7% | 2/2% | 3/3% | 74/72% | 17/17% | 4/4% | 8/8% | 0.022 |
constipation | 64/58% | 37/33% | 7/6% | 3/3% | 53/52% | 43/42% | 4/4% | 3/3% | 0.9 |
wind leak | 37/33% | 38/34% | 26/23% | 11/10% | 43/42% | 41/40% | 4/4% | 3/3% | 0.077 |
urgency to empty | 59/53% | 36/32% | 16/14% | 1/1% | 69/67% | 29/28% | 4/4% | 1/1% | 0.011 |
leak of watery stool | 79/71% | 27/24% | 5/5% | 0 | 84/82% | 16/16% | 3/3% | 0 | 0.143 |
leak of normal stool | 101/90% | 9/8% | 2/2% | 0 | 96/93% | 7/7% | 0 | 0 | 0.022 |
incomplete emptying | 48/43% | 35/31% | 17/15% | 12/11% | 61/59% | 28/27% | 12/12% | 2/2% | <0.001 |
digitation | 71/63% | 24/21% | 2/2% | 15/13% | 80/78% | 16/16% | 4/4% | 3/3% | 0.022 |
not at all | slightly | moderately | greatly | not at all | slightly | moderately | greatly | ||
bother due to bowel symptoms | 52/46% | 30/27% | 9/8% | 21/19% | 71/69% | 19/18% | 10/10% | 3/3% | <0.001 |
Preoperative * | Postoperative ° | p-Value | |||||||
---|---|---|---|---|---|---|---|---|---|
Never | Occasionally | Frequently | Daily | Never | Occasionally | Frequently | Daily | ||
sensation of vaginal bulging | 18/16% | 9/8% | 27/24% | 58/52% | 91/88% | 9/9% | 2/2% | 1/1% | <0.001 |
vaginal pressure/dragging sensation | 9/8% | 12/11% | 21/19% | 69/62% | 90/87% | 10/10% | 3/3% | 0 | 0.37 |
not at all | slightly | moderately | greatly | not at all | slightly | moderately | greatly | ||
bother due to prolapse symptoms | 5/5% | 18/16% | 38/34% | 50/45% | 93/90% | 7/7% | 2/2% | 1/1% | <0.001 |
Preoperative POP-Q Values | Group A * | Group B * | p-Value |
---|---|---|---|
n = 52 | n = 60 | ||
Bp | 0 (−1/0) | 0 (−1/1) | 0.9 |
gh | 4 (3/4.75) | 4 (3/4) | 0.9 |
pb | 3 (2/3) | 3 (2/3) | 0.8 |
Preoperative | Postoperative | p-Value | |||
---|---|---|---|---|---|
straining to | Group A | n = 52 | 2 (1/2) | 2 (1/2) | ns |
empty the bowel * | Group B | n = 60 | 2.5 (2/3) | 2 (1.75/2) | 0.0005 |
laxative use * | Group A | n = 52 | 1 (1/1) | 1 (1/1) | ns |
Group B | n = 60 | 1 (1/1) | 1 (1/2) | ns | |
constipation * | Group A | n = 52 | 1 (1/1) | 1 (1/2) | ns |
Group B | n = 60 | 2 (1/2) | 2 (1/2) | ns | |
wind leak * | Group A | n = 52 | 1.5 (1/2) | 2 (1/2) | ns |
Group B | n = 60 | 2 (2/3) | 2 (1/3) | ns | |
urgency to | Group A | n = 52 | 1 (1/2) | 1 (1/1) | ns |
empty the bowel * | Group B | n = 60 | 2 (1/3) | 1 (1/2) | 0.0014 |
leak of watery stool * | Group A | n = 52 | 1 (1/1) | 1 (1/1) | ns |
Group B | n = 60 | 1 (1/2) | 1 (1/1.25) | ns | |
leak of normal stool * | Group A | n = 52 | 1 (1/1) | 1 (1/1) | ns |
Group B | n = 60 | 2.5 (2/3) | 2 (1.75/2) | ns | |
incomplete | Group A | n = 52 | 1 (1/1) | 1 (1/1.5) | ns |
Emptying * | Group B | n = 60 | 2 (2/3)) | 2 (1/2.25) | ns |
perineal/ | Group A | n = 52 | 1 (1/1) | 1 (1/1) | ns |
vaginal digitation * | Group B | n = 60 | 2 (1/3.75) | 1 (1/2) | 0.002 |
bother due to | Group A | n = 52 | 1 (1/1) | 1 (1/1) | ns |
to bowel symptoms ° | Group B | n = 60 | 2.5 (2/4) | 1 (1/2) | <0.001 |
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Aichner, S.; Studer, A.; Frey, J.; Brambs, C.; Krebs, J.; Christmann-Schmid, C. Analysis of the Clinical Value of Laparoscopic Sacrocolpopexy to Support the Posterior Compartment in Women with Multicompartment Prolapse Including Rectocele. J. Clin. Med. 2024, 13, 5051. https://doi.org/10.3390/jcm13175051
Aichner S, Studer A, Frey J, Brambs C, Krebs J, Christmann-Schmid C. Analysis of the Clinical Value of Laparoscopic Sacrocolpopexy to Support the Posterior Compartment in Women with Multicompartment Prolapse Including Rectocele. Journal of Clinical Medicine. 2024; 13(17):5051. https://doi.org/10.3390/jcm13175051
Chicago/Turabian StyleAichner, Simone, Andreas Studer, Janine Frey, Christine Brambs, Jörg Krebs, and Corina Christmann-Schmid. 2024. "Analysis of the Clinical Value of Laparoscopic Sacrocolpopexy to Support the Posterior Compartment in Women with Multicompartment Prolapse Including Rectocele" Journal of Clinical Medicine 13, no. 17: 5051. https://doi.org/10.3390/jcm13175051