A Comparison of the Postoperative Outcomes of Laparoscopic Sacrocolpopexy and Transvaginal Surgery Using ORIHIME® Mesh with Wide Arms for Pelvic Organ Prolapse.

OBJECTIVES

Both transvaginal mesh surgery with wide arms (TVMWA) and laparoscopic sacrocolpopexy (LSC) are effective surgical treatments for pelvic organ prolapse (POP) with reportedly low recurrence rates. In the present study, we compared the postoperative outcomes of TVMWA and LSC.

MATERIALS AND

METHODS

We retrospectively evaluated 142 patients with POP who underwent LSC or TVMWA at our hospital. We measured the changes in lower urinary tract symptoms before and after surgery using the International Prostate Symptom Score (IPSS) plus Quality of Life (QOL) score, Overactive Bladder Symptom Score (OABSS), International Consultation on Incontinence Questionnaire Short-Form (ICIQ-SF), postvoiding residual urine volume (PVR), and 60-min pad weight testing.

RESULTS

The median blood loss was much lower in the LSC group than in the TVMWA group. However, the median surgical duration was significantly longer in the LSC group than in the TVMWA group (both P < 0.0001). The PVR, IPSS plus QOL scores, OABSS, and ICIQ-SF scores all decreased significantly after surgery in both the groups. There were no significant changes between the pre- and postoperative 60-min pad weights in either group. There were no significant differences in the rate of stress urinary incontinence, mesh exposure, or prolapse recurrence after surgery between the two groups. ICIQ-SF scores were significantly more improved in the TVMWA group compared to the LSC group.

CONCLUSION

We conclude that both TVMWA and LSC are effective surgical methods of ameliorating POP. However, considering the burden such as longer operative time on the patient treated with LSC, we recommend more frequent employment of TVMWA.