Komplikationen, Reprolapsraten und funktionelle Ergebnisse nach laparoskopischer Sakropexie: eine Kohortenstudie

PURPOSE: Deep laparoscopic sacropexy is a modern method to treat genital prolapse. The aim of this study was to evaluate the intermediate-term outcome after laparoscopic sacropexy with regard to the rate of complications, re-prolapse rate and patient satisfaction. MATERIAL AND METHODS: 287 patients suffering from genital prolapse > I° treated by laparoscopic sacropexy were included in the study. LASH (laparoscopic supracervical hysterectomy) was performed in cases where the uterus was still present (n = 171). Anterior and posterior colporrhaphy, lateral repair and anti-incontinence operations were performed simultaneously if necessary. All patients were asked in a questionnaire about de novo symptoms, recurrence and subsequent operations. Patients were asked to evaluate their satisfaction with the operation using a scale (0 = worst result, dissatisfied, 10 = best result, maximum satisfaction). In addition, the medical records of the patients were analyzed. RESULTS: Mean age at operation was 62.4 years (31-91 years). Mean follow-up was 28 months. 84 % (n = 242) of patients completed the questionnaire. No severe intraoperative complications occurred. Infections of the lower urinary tract occurred in 11.4 %, wound infections and stump infection after LASH in 6.6 %. 18.6 % (45/242) patients underwent subsequent operations. Four patients developed a mechanical ileus. 16 patients reported de novo stress incontinence and eight patients de novo urgency. Re-prolapse was reported in 7.8 %. Mesh erosion was seen in two cases. Mean operative satisfaction score was 8.3. CONCLUSION: Laparoscopic sacropexy shows good intermediate-term results with low re-prolapse and complication rates and high patient satisfaction. Infections of the lower urinary tract constitute a problem after gynecological surgery. Information on preoperative risks and benefits should include accurate advice on de novo incontinence and re-prolapse rates.