8988 Laparoscopic Combined Paravaginal Repair, Burch Colposuspension, and Sacral Colpopexy

Abstract

<h3>Study Objective</h3> The objective of this video is to demonstrate an overview of indications, procedural steps, and high-yield anatomy for laparoscopic paravaginal defect repair, Burch colposuspension, and sacral colpopexy. <h3>Design</h3> Surgical video. <h3>Setting</h3> The setting is a community teaching hospital. <h3>Patients or Participants</h3> 54yo G1P1 with grade 3 cystocele, grade 2 rectocele, and uterine prolapse identified on physical exam in the outpatient setting after initially presenting with complaints of pelvic discomfort, vaginal pressure, and sensation of urinary retention. She failed conservative management with pessary and desired definitive management. <h3>Interventions</h3> Total laparoscopic hysterectomy was first performed in routine fashion. Then, laparoscopic paravaginal defect repair, Burch colposuspension, and sacral colpopexy were together performed for correction of pelvic organ prolapse. Burch colposuspension was performed prophylactically to treat potential postoperative stress urinary incontinence. The patient had a stable postoperative course. <h3>Measurements and Main Results</h3> QBL was 50mL. <h3>Conclusion</h3> The risk of requiring surgery for pelvic organ prolapse increases with age. A laparoscopic approach to pelvic organ prolapse correction offers advantages to both the patient and surgeon. Burch colposuspension is an effective additional procedure during pelvic organ prolapse surgery for prophylactic treatment of potential postoperative stress urinary incontinence.