It was reported via journal article: "title: long-term follow-up of laparoscopic sacrocolpopexy".Authors: dimitri sarlos & lavonne kots & gloria ryu & gabriel schaer.Citation: int urogynecol j (2014) 25:1207¿1212; doi 10.1007/s00192-014-2369-y.The aim of this prospective study was to report the long-term follow-up of laparoscopic sacrocolpopexy regarding anatomical results, recurrence rates, and postoperative quality of life after 60 months (mean follow-up).From 2003 to 2007, 99 female patients had laparoscopic sacrocolpopexy for pelvic organ prolapse and were included in the analysis.In the procedure two separate gynemesh were used for anterior and posterior compartments.The most distal part of the posterior mesh was sutured to the levator ani muscle and the proximal mesh to the apex of the vagina or to the cervix.The anterior mesh was placed underneath the bladder and attached to the caudal part of the vagina and the apex with a four-point fixation by laparoscopic suturing using ethibond 2¿0 with the extracorporeal knotting technique.The anterior and posterior meshes were sutured together at the level of the vaginal apex and then attached without tension to the longitudinal sacral ligament at the level of the promontory.In mean follow-up of 60 months complications included de novo stress incontinence (n=32) treated with sling procedure (n=16); postoperative constipation (n=4); postoperative voiding disorders (n=11) for which 2 patients undergo sling transection and the other 9 patients were managed conservatively; de novo urge incontinence (n=7) treated with medical treatment with anticholinergics; severe de novo dyspareunia (n=10) for which 3 patients were treated with local estrogen therapy because of atrophic colpitis; recurrence of anterior wall (n=6) for which two patients were re-operated and treated with an anterior vaginal mesh procedure using prolift due to severe prolapse symptoms and the other four were treated conservatively; recurrence of posterior wall (n=4) for which one patient was treated successfully with posterior repair and the other three patients did not require further treatment as there were asymptomatic; and apical recurrence (n=1) treated with a pessary due to minor symptoms of vaginal bulge.The authors stated that a suboptimal anterior mesh placement probably was not close enough to the trigone of the bladder to be a risk factor for anterior recurrence.Most of the patients reporting dyspareunia at 60 months follow-up was probably not related to the surgery but to other causes such as atrophy.In both cases of mesh erosion, the bladder was accidentally opened during the initial surgery, showing that a bladder lesion, even if it is recognized and repaired immediately, seems to be a risk factor for late mesh erosions into the bladder.It can be mentioned that mesh erosion into the bladder is probably related to surgery and not a mesh-associated problem.Laparoscopic sacrocolpopexy has demonstrated excellent anatomical and functional long-term results.
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