Laparoscopic Sacrocolpopexy or Sacrohysteropexy with or Without Burch Colposuspension: The Results of 36 Patients in Our Clinic

Abstract

OBJECTIVE: Our aim was to investigate the results and the effectivity of laparoscopic sacrocolpopexy or sacrohisteropexy with or without Burch colposuspension in pelvic organ prolapse with or wihout urinary incontinence patients in our clinic.

MATERIAL AND METHOD: From January 2011 to January 2015 we performed laparoscopic sacrocolpopexy or sacrohysteropexy with or without Burch colposuspension for pelvic organ prolapse in 36 selected patients. Demographic and clinical data, intraoperative findings and postoperative course were recorded. POP-Q examination was used for pelvic prolapsed patients. Burch colposuspension was added to patients if they had stress urinary incontinence proven with physically examination and urodinamic tests. Twenty two patients underwent laparoscopic sacrocolpopexy or sacrohysteropexy and 14 patients underwent laparoscopic sacrocolpopexy or sacrohysteropexy with Burch colposuspension.

RESULTS: Laparoscopic sacrocolpopexy without Burch colposuspension (Group 1) (n=22) group’s mean operation time and the mean blood loss were 51.1±11.8 minutes (range: 40-85 min.) and 39.3±13.9 cc (range: 30-70 cc) respectively. Laparoscopic sacrocolpopexy with Burch colposuspension (Group 2) (n=14) group’s mean operation time and the mean blood loss were 88.5±13.5 minutes (range: 85-100 min.) and 65.0±11.0 (range: 60-80 cc) respectively (for mean operation time p=<0.001, for mean blood loss p=<0.001). Nine of the patients had operations with uterus preservation. All patients were discharged the following day. In Group 2 two patients developed denovo detrusor instability and improved with the administration of oxybutynin. In group 1 postoperatively, 8 patients developed denovo urinary incontinence. In the treatment of this condition we have added two patients Burch colposuspension operations, 6 patients underwent transobturatuar tape TOT. Two patients did not want to have reoperations, they received medical treatment.

CONCLUSION: Laparoscopic sacrohysteropexy or sacrocolpopexy with Burch colposuspension offer minimally invasive approaches and excellent definitive treatment option for patients with pelvic organ prolapse and urinary incontinence with long-term success rates ranging from 93-99%. In our study, our data shows that laparoscopic approaches for treatment of pelvic organ prolapse and urinary incontinence effective in hysterectomized or non-hysterectomized patients. Long-term prospective studies may provide additional useful data for these procedures.