A report of laparoscopic promontofixation with uterine preservation

Abstract

ABSTRACT Background: Pelvic organ prolapse is a common disease, accounting for 31.8% to 97.7% of women at clinical examination, of which clinical symptoms account for 2.9% to 11.4%. Pelvic floor disorders, including urinary incontinence, anal incontinence, and genital prolapse, are highly prevalent, affecting approximately one-third of adult women. While these conditions are not life-threatening, their social and economic consequences may be significant. Nowadays, there are many methods to treat female pelvic prolapse, including laparoscopic surgery, laparotomy and vaginal surgery. Choosing a method of treating pelvic organ prolapse is still controversial. Endoscopic surgery is a method having many advantages. In this study, we reported the treatment results for Pelvic organ prolapse by laparoscopic promontofixation without hysterectomy. Methods: A study was conducted on 19 female patients with pelvic organ prolapse, who were treated with the laparoscopy promontofixation for uterin preservation at Hue Central Hospital from June 2019 to June 2021. Results: The average age was 65 years old, the rate of hard work was 77.8%, and the average number of births was 3.8. The rate of macrosomia is 28%. The rate of bladder prolapse stage 2 accounted for 42%, and bladder prolapse stage 3 accounted for the highest rate of 58%. The stage 2 cervical prolapse rate was 32%, of which stage 3 cervical prolapse accounted for the highest rate of 68%. The stage 1 rectal prolapse rate was 50%, and stage 2 rectal prolapse was 1%, of which stage 3 was 42%. The rate of urinary incontinence was 89%. The median hospital stay for surgery was 6.57 days. The average time for laparoscopic promontofixation was 142 minutes, of which the longest time was 180 minutes and the fastest was 60 minutes. There were no complications during surgery. Complications appear after surgery: Burning pain in the lower abdomen was highest at 44%, dull pain in the low back at 33%, constipation at 22%, cystitis at 11%, pain when defecating at 11%. The success rate of the treatment of bladder prolapse after surgery was 100%, the success rate of cervical prolapse was 87.5%, the success rate of rectal prolapse was 88.9%. The rate of no urinary incontinence after 12 months was 75%, the success rate of dysuria treatment was 100%. Conclusions: Our initial experience renders the use of laparoscopic promontofixation with uterine preservation to be safe and efficient in experienced hands. However, it is difficult to perform this technique; the number of samples is small, and we need further research.