Department of Obstetrics and Gynecology, Gaziosmanpasa Research and Training Hospital affiliated with the University of Health Sciences, Istanbul, Turkey.
J Obstet Gynaecol Res. 2023 Jan;49(1):341-349. doi: 10.1111/jog.15459. Epub 2022 Oct 5.
Apical prolapse is an important component of pelvic organ prolapse. The aim of our study was to investigate the effectiveness of laparoscopic lateral suspension (LLS) surgery, which we performed while sparing the uterus.
LLS surgery was performed on 62 patients due to apical prolapse, preserving their uterus. The patients' pelvic organ prolapse quantification system (POP-Q) points and sexual function using pelvic organ prolapse/urinary incontinence sexual function questionnaire (PISQ-12) prior to and 12 months following the surgery were compared, and the results were evaluated.
The POP-Q points and PISQ-12 scores evaluating sexual function of the patients who underwent LLS were significantly improved compared to pre-operation values (p ˂ 0.001). No intraoperative complications were observed in the patients. Recurrence was observed in 6 (9.6%) of 62 total cases in post-operative follow-up. Apical prolapse was seen in two patients (3.2%), and anterior vaginal wall recurrence was observed in one patient (1.6%). Posterior vaginal wall recurrence was seen in three patients (4.8%). Pelvic pain complications were observed in four patients (6.4%) in the postoperative follow-up. Mesh erosion was not observed in any of the cases. It was observed that 5 (38%) of 13 patients with stress urinary incontinence (SUI) had improved SUI complaints after surgery. The mean operation time was 66.3 ± 12.3 min.
LLS is an effective and safe method for patients with apical prolapse who want to preserve their uterus. LLS can be applied as an alternative to the sacrocolpopexy procedure, which has risks such as potentially serious neurological and life-threatening vascular injury in the sacral region.
子宫顶端脱垂是盆腔器官脱垂的一个重要组成部分。我们的研究目的是探讨腹腔镜侧方悬吊带术（LLS）的有效性，该手术在保留子宫的同时进行。
对 62 例因子宫顶端脱垂而接受 LLS 手术的患者保留了其子宫。比较了患者术前和术后 12 个月的盆腔器官脱垂量化系统（POP-Q）点和盆腔器官脱垂/尿失禁性功能问卷（PISQ-12）评估的性功能，并对结果进行了评估。
与术前相比，接受 LLS 手术的患者的 POP-Q 点和评估性功能的 PISQ-12 评分均显著改善（p<0.001）。术中未观察到任何并发症。在术后随访中，62 例患者中有 6 例（9.6%）复发。术后 2 例（3.2%）出现子宫顶端脱垂，1 例（1.6%）出现前阴道壁复发，3 例（4.8%）出现后阴道壁复发。4 例（6.4%）患者在术后随访中出现盆腔疼痛并发症。所有病例均未观察到网片侵蚀。术后 13 例压力性尿失禁（SUI）患者中，5 例（38%）的 SUI 抱怨得到改善。手术平均时间为 66.3±12.3 分钟。
对于希望保留子宫的子宫顶端脱垂患者，LLS 是一种有效且安全的方法。LLS 可作为骶骨区域存在严重潜在神经和危及生命的血管损伤风险的骶骨阴道固定术的替代方法。
