改良的经后路阴道壁悬吊术在盆底重建中的应用

目的 探讨应用改良的经后路阴道壁悬吊(PVWH)术治疗盆腔器官脱垂,同时保留子宫,及进行盆底重建的可行性和有效性。方法对32例有不同缺陷的盆腔器官膨出患者进行改良的PVWH术。应用聚丙烯网片悬吊双侧骶棘韧带,将脱垂的子宫复位;经阴道放置悬吊带,以加固子宫骶骨韧带;在应用聚丙烯网片形成新的阴道直肠筋膜的同时,加固肛提肌板,完成中后盆底重建。根据国际尿控协会制定的盆腔器官脱垂定量(POP-Q)分度法,评价手术效果。结果改良的PVWH术的手术时间平均为55min,出血量平均为150ml。根据POP-Q分度法,32例患者的子宫脱垂全部得到纠正;平均随访7个月,均未出现阴道扭曲、缩短,无性生活障碍。除1例患者出现宫颈延长外,其余无复发;各种症状改善率≥50％。结论改良的．PVWH术,对子宫脱垂患者在保留子宫的同时行中后盆底重建的短期疗效稳定,长期疗效尚有待进一步观察。     

子宫切除术与盆腔器官脱垂

盆腔器官脱垂（POP）是施行子宫切除术的常见原因之一,但子宫切除术也可能是未来发生POP的原因。本文主要阐述子宫切除术与POP之间的关系、子宫切除术后是否行预防性或治疗性阴道顶端悬吊术（ASP）、盆底修补手术是否同时行子宫切除术等热点问题。子宫切除术与POP,从盆底解剖结构到术式选择及治疗预后有着密切而复杂的关系。因非...     

腹腔镜阴道骶骨固定术治疗盆腔器官脱垂的临床应用研究

目的探讨腹腔镜阴道骶骨固定术治疗中盆腔器官脱垂合并阴道前后壁脱垂的治疗效果。方法回顾性分析自2014年12月至2016年12月间因中盆腔器官脱垂和(或)伴阴道前后壁脱垂接受腹腔镜阴道骶骨固定术的患者资料,共30例(研究组);选取同期因中盆腔脱垂和(或)伴阴道前后壁脱垂Ⅲ期行阴式全子宫切术或(和)阴道前后壁修补术的患者30例为对照组。所有入组患者盆腔器官脱垂定量分期法(POP-Q)≥Ⅲ期。比较两组患者的围术期及术后3个月和6个月随访情况,对手术效果进行主客观评价。结果两组患者手术时间、术中出血量、术后住院时间比较,差异无统计学意义(P0.05)。术后3、6个月,研究组均无复发,对照组复发率分别为6.67%(2/30)和20.0%(6/30),3个月复发率比较,差异无统计学意义(P0.05),6个月复发率比较,差异有统计学意义(P0.05)。结论腹腔镜阴道骶骨固定术对POP-Q在Ⅲ期以上的中盆腔器官脱垂合并阴道前后壁脱垂有良好的效果,术后不易复发。     

腹腔镜骶骨固定术与其他顶端悬吊术式的比较

随着社会老龄化的进一步加重及人们生活质量的进一步提高，盆腔器官脱垂（POP）的发病率及就诊率也逐渐增高。中盆腔缺陷是阴道顶端支持结构缺陷，以子宫或阴道穹隆脱垂以及肠膨出、穹隆疝形成为主要特征，是POP中的常见类型。治疗中盆腔缺陷的手术方式众多，主要有骶骨固定术、宫骶韧带悬吊术、骶棘韧带固定术、曼式手术和经阴道网片置入手术等。文章对纠正中盆腔缺陷的各类术式进行了综合分析与比较。     

经阴道自然腔道内镜阴道骶骨固定术治疗盆腔器官脱垂疗效研究

目的探讨经阴道自然腔道内镜(vNOTES)阴道骶骨固定术治疗盆腔器官脱垂(POP)的疗效。方法收集2017年6月至2018年9月在广州医科大学附属第三医院行vNOTES阴道骶骨固定术的POP患者33例,记录手术时间、术中出血量及术后并发症等指标,评估手术的安全性。术后定期随访,应用POP-Q客观评估手术效果,使用盆底疾病生活质量影响问卷简表(PFIQ-7)评估疗效。结果术中除3例中转为经脐单孔腹腔镜外,余30例均顺利完成手术。手术时间(184.97±41.91)min,术中出血量(28.33±18.77)mL,术后暂未发现网片暴露、感染等并发症。术后随访1、3、6个月,POP-Q各指示点位置均较术前明显改善(P0.05),术后生活质量恢复优于术前(P0.05)。结论 vNOTES阴道骶骨固定术治疗POP安全可行,短期随访疗效肯定。     

全子宫切除术后穹隆疝的手术处理及临床分析

目的探讨因子宫脱垂或其他因素行全子宫切除术后发生穹隆疝的处理方式。方法对2011年1月至2015年12月就诊于中国医科大学附属盛京医院行全子宫切除术后发生盆腔器官脱垂107例及其中的80例穹隆疝患者的手术处理方式进行回顾性分析。结果 107例患者中,单纯膀胱膨出或直肠膨出27例;以穹隆膨出为主,伴或不伴有膀胱和直肠膨出80例。80例患者中,子宫脱垂行全子宫切除32例,其他原因行全子宫切除48例;重度压力性尿失禁14例,尿动力学提示隐匿性尿失禁3例;行经阴道置入网片的盆底重建术76例,其中全盆底重建术56例,中盆腔重建术20例;2例腹腔镜下阴道骶骨固定术,1例单纯疝囊修补术,1例前盆底重建术+疝囊修补术。17例压力性尿失禁患者中,16例术中同时行TVT-O术。随访至2016年12月,平均随访时间38个月,无复发病例,3例患者出现网片暴露,1例隐匿性尿失禁患者于术后1年因尿失禁症状较重,行TVT-O手术。结论置入网片的盆底重建术是治疗子宫切除术后阴道穹隆疝的一种有效的手术方式,术前根据穹隆疝及合并阴道前后壁脱垂的程度选择恰当的手术重建方式。对于术前合并压力性尿失禁或隐匿性尿失禁患者术中应同时行TVT-O手术。     

骶骨固定术临床价值分析

骶骨固定术是利用网片或其他移植物,将阴道顶或子宫固定于骶骨前纵韧带,用于治疗盆腔器官脱垂（pelvic organ prolapse,POP）的一种经典手术方式,其发展史经历了从开腹到腹腔镜再到经阴道单孔腹腔镜的不断改良和完善的过程。近年来,新兴的经阴道单孔腹腔镜骶骨固定术（transvaginal single port laparoscopic sacrocolpopexy,VLSC）,结合了阴式手术与腹腔镜手术的优点,不仅具有腹壁无瘢痕、术后疼痛更轻、恢复更快等更加微创的优点,而且具有较高的主观和客观治愈率,以及较低的网片相关并发症,有望成为治疗POP的常规术式。     

骶骨固定术临床价值分析

骶骨固定术是利用网片或其他移植物,将阴道顶或子宫固定于骶骨前纵韧带,用于治疗盆腔器官脱垂（pelvic organ prolapse,POP）的一种经典手术方式,其发展史经历了从开腹到腹腔镜再到经阴道单孔腹腔镜的不断改良和完善的过程。近年来,新兴的经阴道单孔腹腔镜骶骨固定术（transvaginal single port laparoscopic sacrocolpopexy,VLSC）,结合了阴式手术与腹腔镜手术的优点,不仅具有腹壁无瘢痕、术后疼痛更轻、恢复更快等更加微创的优点,而且具有较高的主观和客观治愈率,以及较低的网片相关并发症,有望成为治疗POP的常规术式。     

73例腹腔镜子宫/阴道骶骨固定术治疗盆腔器官脱垂的疗效观察

目的:探讨腹腔镜子宫/阴道骶骨固定术对盆腔器官脱垂(POP)患者的临床疗效。方法:分析2012年11月至2017年8月我院经POP定量分度法(POP-Q)证实为阴道穹窿脱垂Ⅱ期以上、中盆腔缺陷为主的POP初治患者(≥Ⅲ期)以及部分POP手术后复发患者73例,分别行腹腔镜子宫/阴道骶骨固定术。手术前后分别依据POP-Q、国际尿失禁调查问卷(ICIQ-SF)、盆底功能障碍疾病相关问卷-简要版(PFDI-20)、盆底疾病生活影响问卷-简易版7(PFIQ-7)、盆底器官脱垂/尿失禁对性功能影响的调查问卷(PISQ-12)、尿失禁生活质量影响问卷(I-QOL)、泌尿生殖道疾病相关问卷-6(UDI-6)、尿失禁影响程度相关问卷-7(IIQ-7)分别评价解剖和功能疗效。结果:73例患者均成功完成手术,4例行腹腔镜下子宫骶骨固定术,5例行经阴道全子宫切除术+腹腔镜下骶骨固定术,64例行腹腔镜下全子宫切除术+骶骨固定术。POP-Q分期Aa、Ba、C、Ap、Bp各指示点解剖位置均数由术前(2.12±1.27)cm、(3.66±2.92)cm、(2.65±2.68)cm、(0.79±1.91)cm、(1.56±3.04)cm分别恢复为术后(-2.72±0.21)cm、(-2.74±0.19)cm、(-6.60±2.88)cm、(-2.50±0.69)cm、(-2.37±1.08)cm。PFIQ-7、PFDI-20评分由术前(33.71±11.12)、(49.69±10.02)分恢复为(2.01±6.11)、(3.03±10.02)分,I-QOL评分由术前(79.40±27.64)分提高到(106.96±13.02)分(P0.001)。结论:腹腔镜子宫/阴道骶骨固定术可恢复盆腔脱垂患者POP-Q正常解剖结构,显著提高患者的生活质量及性生活质量,客观满意度高,治疗效果满意。     

腹腔镜骶骨固定术保留子宫或子宫颈的利弊

盆腔器官脱垂（pelvic organ prolapse,POP）是由于女性盆底肌肉和筋膜等支持组织功能减退导致的盆腔器官下移及功能障碍，发病人群以中老年女性为主，严重影响患者的生活质量。症状性中重度POP的治疗方法以手术为主，腹腔镜骶骨固定术被认定为治疗阴道顶端脱垂或中盆腔缺陷的“金标准”术式，临床根据是否保留子宫或子宫颈分为子宫/子宫颈骶骨固定术和阴道骶骨固定术，前者适用于有保留子宫意愿且排除禁忌证的患者，特别是年轻、性生活活跃的患者。文章就腹腔镜骶骨固定术中保留子宫或子宫颈的利弊进行探讨。     

Laparoscopic Uterosacral Ligament Hysteropexy vs Total Vaginal Hysterectomy with Uterosacral Ligament Suspension for Anterior and Apical Prolapse: Surgical Outcome and Patient Satisfaction

Study ObjectiveTo compare anatomic and clinical cure rates as well as patient satisfaction between uterine-preserving laparoscopic uterosacral ligament suspension and total vaginal hysterectomy with uterosacral ligament suspension in women with apical and anterior prolapse.DesignSingle-center clinical comparative retrospective cohort study.SettingA female pelvic medicine and reconstructive surgery service at a tertiary teaching hospital.PatientsWomen with pelvic organ prolapse who underwent surgical treatment for their condition between July 2010 and December 2015.InterventionsAll women underwent laparoscopic uterosacral ligament suspension or total vaginal hysterectomy with uterosacral ligament suspension for apical and anterior prolapse. Concomitant procedures included anterior and posterior repair, as well as a midurethral sling when indicated.Measurements and Main ResultsPreoperative and postoperative Pelvic Organ Prolapse Quantification (POP-Q) measurements were obtained. The primary outcome was clinical cure rate. Secondary outcomes included anatomic cure rate and outcomes of site-specific POP-Q points Ba, C, and Bp for the whole cohort. Patient satisfaction was measured using the Patient Global Impression of Improvement questionnaire. During the study period, 106 women underwent transvaginal hysterectomy with uterosacral ligament suspension, and 53 women had laparoscopic uterosacral ligament suspension. At a mean follow-up of 14.7 ± 13.23 months for the vaginal group and 17.5 ± 15.84 months for the laparoscopic group (p = .29), there were significant improvements of POP-Q points Ba, C, and Bp (p < .0001 for all comparisons in both groups). The clinical cure rate was 96% in the vaginal group and 98% in the laparoscopic group (p = .50). The anatomic cure rate was 85.4% in the vaginal group and 93.75% in the laparoscopic group (p = .11) Patient satisfaction was high in both groups.ConclusionIn appropriately selected patients, laparoscopic uterosacral ligament suspension is a valid uterus-preserving option for women with anterior and apical prolapse, associated with high anatomic and clinical cure rates and patient satisfaction.     

经阴道单孔腹腔镜下骶棘韧带悬吊术治疗盆腔器官脱垂效果分析

目的 探讨分析盆腔器官脱垂患者行经阴道单孔腹腔镜下骶棘韧带悬吊术治疗的临床效果.方法 选取70例盆腔器官脱垂患者,根据治疗方式不同分为对照组与研究组,每组35例.对照组行经阴道骶棘韧带固定术治疗,研究组行经阴道单孔腹腔镜下骶棘韧带悬吊术治疗.对比两组患者围术期指标以及治疗前后盆腔器官脱垂定量分期法(POP-Q)中相关指...     

Positive symptom improvement with laparoscopic uterosacral ligament repair for uterine or vaginal vault prolapse: interim results from an active multicenter trial

STUDY OBJECTIVE: To evaluate the use of laparoscopic uterosacral ligament repair for long-term patient symptom improvement in patients with uterine prolapse or posthysterectomy vaginal vault prolapse and to evaluate how laparoscopic instrumentation kits facilitate procedure performance for the surgeon. DESIGN: Nonrandomized, prospective, multicenter case series (Canadian Task Force classification II-2). SETTING: Five clinical sites consisting of 4 community hospitals and 1 university medical center. PATIENTS: Seventy-two patients with stage II or worse uterine prolapse (58%, n = 42) or posthysterectomy vaginal vault prolapse (42%, n = 30). One patient with stage I vaginal vault prolapse was included in the group due to her significant symptoms. INTERVENTIONS: Laparoscopic uterosacral ligament repair was performed on all patients; round ligament truncation was also performed selectively on patients with uterine prolapse. Fifty-seven percent (41 patients) had concomitant pelvic procedures. MEASUREMENTS AND MAIN RESULTS: At 12-month follow-up, Pelvic Organ Prolapse Quantification (POP-Q) scores and patient self-reported symptom scores were significantly improved over baseline after laparoscopic repair of pelvic organ prolapse. Positive mean change in POP-Q score was 14.4 (p = .0003) for uterine prolapse repair and 9.28 (p = .017) for vaginal vault prolapse repair. Positive mean change in total symptom score was 20.36 (p <.0001) for uterine prolapse repair and 11.43 (p = .005) for vaginal vault prolapse repair. Surgeons reported a mean procedure time of 31.6 minutes for uterine prolapse repair and 21.7 minutes for vaginal vault prolapse repair. A mean rating of 7.5 was documented for ease of use for the uterine prolapse kit and 4.1 for the vaginal vault prolapse kit on a scale of 1 to 10. CONCLUSION: Laparoscopic uterosacral ligament repair improves symptoms and POP-Q scores over the long term in patients with uterine or vaginal vault prolapse. Laparoscopic instrumentation kits facilitate procedure performance for the surgeon with expedited surgery times.     

经阴道子宫骶骨韧带高位悬吊术治疗子宫脱垂的临床探讨

目的探讨经阴道子宫骶骨韧带高位悬吊术（HUS）治疗子宫脱垂的解剖生理基础、适应证、手术技巧、输尿管损伤的预防及临床近、中期疗效。方法2003年6月至2007年9月,采用经阴道HUS悬吊阴道穹隆、重建耻骨宫颈筋膜及直肠阴道筋膜,治疗中、重度子宫脱垂50例。患者平均年龄60．1岁,术后平均随访时间24个月（4～51个月）。同时采用盆腔器官脱垂定量分度（POP-Q）法对子宫脱垂程度及手术后结果进行评价,以术后C点值≤POP-QⅠ度计算成功率。结果术中50例中、重度子宫脱垂患者的宫骶韧带均可在后腹膜坐骨棘内后侧、经长组织钳钳夹牵拉、清楚触及和辨认,并均成功对阴道穹隆进行了悬吊和筋膜重建。术中应根据对输尿管解剖部位和相邻关系的准确认识、术中触摸、掌握缝合进针深度及方向、膀胱镜检查并确认输尿管开口位置等方法避免输尿管损伤。50例中,无一例输尿管损伤。术后平均随访时间24个月,POP-Q法C点值由术前1．5cm降为术后的-7．5cm;主、客观成功率均达100％。结论经阴道HUS悬吊并重建阴道穹隆、耻骨宫颈筋膜、直肠阴道筋膜是利用自身组织作为悬吊点治疗子宫脱垂,符合恢复解剖生理、保留功能及微创原则,主、客观成功率高。     

两种保留子宫治疗子宫脱垂的手术方式的疗效分析

目的:探讨腹腔镜下子宫腹壁悬吊术及子宫骶骨岬悬吊术治疗要求保留子宫的女性盆腔脏器脱垂患者的可行性及临床疗效。方法:回顾分析2012年6月1日至2013年6月1日郑州大学第一附属医院收治的64例要求保留子宫的子宫脱垂患者的临床资料,其中34例行腹腔镜下子宫腹壁悬吊术(研究组),30例行子宫骶骨岬悬吊术(对照组)。比较两组患者的手术时间、术中出血量、住院天数及术后并发症,术后12个月测量患者POP-Q各点值评价术前术后盆底功能改善状况,以盆底不适调查表短表20(PFDI-20)评价手术前后患者的生活质量。结果:64例患者均经腹腔镜成功完成手术,术中无膀胱、输尿管、直肠损伤。研究组的手术时间、术中出血量、住院天数均少于对照组,差异均有统计学意义(P0.05)。术后随访12个月,两组患者均无子宫脱垂复发,POP-Q各点测量值差异无统计学意义(P0.05);两组的术前与术后生活质量调查表问卷得分比较,差异有统计学意义(P0.05)。研究组和对照组分别有3例(8.8%)和2例(6.7%)发生术后并发症。结论:腹腔镜下腹壁子宫悬吊术及子宫骶骨岬悬吊术治疗子宫脱垂安全有效;腹腔镜下腹壁子宫悬吊术具有手术时间短、术中出血量少、经济安全、术后并发症少等优点,有望临床推广。     

经阴网片全盆重建术治疗重度盆腔器官脱垂中长期临床疗效评价

目的 探讨经阴网片全盆重建手术治疗盆腔器官脱垂的疗效及并发症,评估该手术的有效性和安全性。方法 回顾性分析2007年1月至2014年6月在广州医科大学附属第一医院因盆腔器官脱垂行经阴网片全盆重建术110例患者的临床资料,比较手术前后盆腔器官脱垂定量分期法(POP-Q)各指示点位置,评价总体客观治愈率及复发率。采用盆底功能障碍性疾病症状问卷简表(PFDI-20)等相关问卷评分评价主观治愈率以及术后尿失禁相关症状改善情况。结果 110例患者中失访12例（12/110, 10.91%）,其中1例因心血管疾病术后1年余死亡,随访98例（98/110, 89.09%）。随访时间6～90个月,中位随访时间：48个月。110例患者年龄(65.30±8.00)岁;绝经时间(14.01±9.08)年;采用POP-Q分期评价,术后15例（15/98,15.31%）出现复发,其中11例POP-Q分期Ⅱ期,无主观症状不需再次手术,4例阴道顶端复发（POP-Q Ⅲ期）,需再次手术治疗。术后主观治愈率95.92%(94/98）,客观治愈率84.69%(83/98）;网片挛缩4例（4/98, 4.08%）,网片外露11例（11/98,11.22%）。术后PFDI-20评分与术前比较,差异有统计学意义(P<0.05);术后性生活13例,其中性生活质量5例满意,6例患者较术前差,2例配偶出现性交疼痛;患者总体术后满意度评分满意率95.91%(94/98)。结论 经阴网片全盆重建术用于治疗重度盆腔器官脱垂主、客观治愈率高,不仅能达到较好的解剖学复位,对患者的盆腔器官脱垂相关症状有明显改善,术后满意度高且长期疗效稳定,但对性生活质量无明显改善。     

经阴道前壁路径骶棘韧带悬吊术治疗盆腔器官脱垂的短期疗效分析

目的:观察经阴道前壁路径骶棘韧带悬吊术治疗盆腔器官脱垂(POP)的短期疗效及安全性。方法:回顾性分析2014年2月至2015年8月在皖南医学院附属弋矶山医院行经阴道前壁路径骶棘韧带悬吊术的51例POP患者的临床资料。观察手术时间、手术出血量、住院时间、尿管留置时间,并发症情况,治愈率,生命质量改善情况。结果:患者的平均手术时间为(75.20±24.31)min,平均术中出血量(87.65±74.72)ml,平均术后住院天数(4.31±0.75)天,平均留置尿管时间(3.50±1.30)天。完整随访51例,随访率为100.00%,3例术后复发,治愈率为94.12%。术前与术后POP-Q的Aa、Ba、Ap、Bp、C比较、盆底功能障碍问卷(PFDI-20)评分比较,差异均有统计学意义(P0.05)。术后1月与术后6月阴道前壁Aa、Ba、C点比较,差异无统计学意义(P0.05)。结论:经阴道前壁路径骶棘韧带悬吊术是一种安全、有效的术式,在治疗合并前盆腔缺陷的POP疾病中较传统方式具有优势。     

苯丙酮尿症患儿脑髓鞘发育延迟与血苯丙氨酸浓度关系的研究

目的应用MRI观察苯丙酮尿症(PKU)患儿脑髓鞘发育延迟与血苯丙氨酸(PHE)浓度的关系。 方法对2002—2004年北京中日友好医院PKU门诊确诊的经典型PKU患儿29例，治疗前进行头颅MRI及血苯丙氨酸浓度检查，脑髓鞘发育按Staudt标 准对不同年龄阶段患儿脑10个区域进行量化评估。HPLC法定量测定血PHE浓度。根据开始接受治疗年龄不同分为甲(28~48周，11例)、乙(49~390 周，18例)两组,另随机选取其中19例治疗１年后复查MRI进行治疗前后对照,根据该19例治疗中血苯丙氨酸浓度控制情况分为A组(血PHE控制在 0.12~0.48mmol/L)和B组(血PHE控制在0.12~0.48mmol/L以外)。 结果29例患儿治疗前均存在髓鞘发育延迟,在10个脑区域髓鞘发育延迟平均发生率为45.6%，主要部位在脑叶和胼胝体,其中甲组髓鞘发育延迟平 均发生率为40.8%,乙组发生率为51.2%,甲乙组间差异有显著性意义(P<0.05);经低苯丙氨酸饮食治疗1年后,19例10个脑区域髓鞘发育延迟平均发 生率为32.2%;治疗前后髓鞘延迟有显著性改善(P<0.01),且治疗中血PHE浓度控制较好的A组髓鞘延迟改善率为1.75±0.66,B组病例为0.78± 0.44,差异有显著性(P<0.01),髓鞘延迟改善与血PHE浓度间有密切相关性。 结论治疗延迟的PKU患儿的脑髓鞘发育延迟的高发病率，与高血PHE浓度影响时间有关;经低苯丙氨酸饮食治疗延迟的改善率，与治疗中血PHE浓 度控制情况直接影响延迟改善,因此提示PKU患儿血PHE浓度是影响脑髓鞘发育延迟发生及改善的重要原因。     

Abdominal sacral colpopexy in patients with gynecologic cancer: report of 25 cases with long-term follow-up and literature review

OBJECTIVE: The aim of this study was to evaluate abdominal sacral colpopexy performed in conjunction with radical pelvic surgery for gynecologic cancer. METHODS: Over a 9-year period from 1990 to 1999 25 patients with invasive gynecologic cancer and concomitant uterovaginal or vaginal vault prolapse underwent surgery. These patients were compared to a series of 50 patients with no history of gynecologic cancer who underwent abdominal sacral colpopexy during the same period. RESULTS: All surgeries were performed without intraoperative complication. There was one failed vault suspension in each group and no postoperative mesh complications as a result of radical pelvic surgery or postoperative radiation or chemotherapy. CONCLUSION: Abdominal sacral colpopexy may be safely performed along with radical pelvic surgery for gynecologic cancer without an increase in intra- or postoperative morbidity even if patients require chemotherapy or radiation therapy after surgery.     

Implementation of laparoscopic sacrocolpopexy: establishment of a learning curve and short-term outcomes

Purpose

To evaluate the learning curve of senior urogynecologic surgeons performing laparoscopic sacral colpopexy (LSCP) and to assess outcomes and complications of LSCP.

Methods

We conducted a retrospective study of 47 consecutive women who underwent LSCP for pelvic organ prolapse repair between March 2009 and December 2010 at one tertiary medical center. Preoperative, intraoperative, postoperative, and demographic data were retrieved from patients’ electronic charts. Pelvic organ support was assessed objectively using the Pelvic Organ Prolapse Quantification scale (POP-Q). Anatomic failure was determined as POP-Q stage?≥?II.

Results

The mean age of patients was 58?years (range 35–73?years). Seven (15?%) who opted to retain their uterus underwent sacrohysteropexies. The median POP-Q was III (II–IV). Of the 47 operations, 96?% (45) were completed by laparoscopy. The duration of surgery decreased as experience of the surgical team increased, from a mean of 196?±?62?min for the first 15 cases to 162?±?30?min for the subsequent 30. Four patients (9?%) presented with recurrence of prolapse; three (7?%) had de novo stress urinary incontinence; two sustained a cystotomy during adhesiolysis, and one had a port-site hernia.

Conclusions

LSCP is a safe and effective treatment for pelvic organ prolapse, with very few complications. Following the first 15 cases of one surgical team, operative time decreased considerably.