Introduction: The purpose of the study was to compare the outcome of laparoscopic sacral colpo-cervicopexy with laparoscopic pectopexy.
Our aim was to show that the safety and effectiveness of the new technique is similar to the traditional technique. We expected differences regarding defecation disorders.
Material and Methods: We randomly assigned patients to two treatment groups: 44 in the pectopexy and 41 in the sacropexy group. If necessary, the operative procedures were planned in a so-called multi-compartment setting regarding the different pelvic floor disorders. All defects were treated at the same time. Eighty-one patients were examined 12-37 months after treatment (mean follow-up 20.67 months).
Results: The long-term follow-up (21.8 months for pectopexy and 19.5 months for sacropexy) showed a clear difference regarding de novo defecation disorders (0% in the pectopexy versus 19.5% in the sacropexy group). The incidence of de novo stress urinary incontinence (SUI) was 4.8% (pectopexy) vs 4.9% (sacropexy). The incidence of rectoceles (9.5% vs 9.8%) was similar in both groups. No de novo lateral defect cystoceles were found after pectopexy, whereas 12.5% were found after sacropexy. The apical descensus relapse rates, 2.3% for pectopexy versus 9.8% for sacropexy, were not statistically significant. The occurrence of de novo anterior defect cystoceles and rectoceles revealed no significant differences. Summary Laparoscopic pectopexy is a novel method of vaginal prolapse therapy that offers clear practical advantages compared to laparoscopic sacropexy. As laparoscopic pectopexy does not reduce the pelvic space, it results in a zero percentage of defecation disorders.
Written by:
Noé KG, Schiermeier S, Alkatout I, Anapolski M. Are you the author?
University of Witten Herdecke, Gynecology Hospital of Dormagen, Dormagen, Germany, University of Witten Herdecke, Witten, Germany.
Reference: J Endourol. 2014 Oct 28. Epub ahead of print.
doi: 10.1089/end.2014.0413
PubMed Abstract
PMID: 25350228