Glue mesh fixation: Feasibility, tolerance and complication assessment. Results 24 months after laparoscopic sacrocolpopexy

Abstract

AimThis study aims to assess short- and mid-term feasibility, strength and tolerance of glue mesh fixation for laparoscopic sacrocolpopexy, as well as postoperative quality of sexual activity. Patients and methodsThis original prospective clinical study was carried out in multiple university surgical centres between 2012 and 2013. Data were obtained during immediate postoperative hospitalisation, at 3 and at 24 months postoperatively. For a total of 42 patients subjected to laparoscopic sacrocolpopexy, bladder catheterization and hospitalisation times, pain score, early and late postoperative complications, prolapse staging according to POP-Q classification, and quality of sexual activity were registered. ResultsMean operative time was 120minutes and patients were hospitalised for a mean of 3days. Four complications (9.52%) occurred on the immediate postoperative period, whilst 2 patients (4.76%) complained of pain on day 3 (VAS 1). At the end of the follow-up period (24 months), one patient had a prosthetic exposure, 4 patients (9.52%) complained of stress urinary incontinence (10.81%). Simultaneously, 6 patients (14.29%) experienced dyschezia (2 improved, 1 similar, 1 de novo, 2 worsened), and there was no report of dyspareunia. All anterior and posterior floor prolapses were staged between 0 and 1. All superior floor prolapses were staged between 0 and 2. Concerning sexual impairment, there was no report of dyspareunia, urinary leaks or other problems associated with intercourse, and quality of sexual activity improved. ConclusionMinimally invasive sacrocolpopexy with the use of glue fixation does not lead to increased mid-term morbidity, simultaneously allowing for significant prolapse improvement, and providing global patient satisfaction and overall quality of life.