Risk of de novo posterior vaginal prolapse after anterior laparoscopic sacrocolpopexy: Evaluation at one year

Abstract

Introduction and hypothesisTreatment of anterior vaginal and/or apical prolapse by sacrocolpopexy is most often performed by systematic placement of two non-resorbable meshes, anterior and posterior, whether or not there is an associated posterior vaginal prolapse. We believe that isolated correction of an anterior vaginal and/or apical prolapse in the absence of posterior vaginal prolapse is not associated with a higher rate of de novo posterior vaginal prolapse. MethodA prospective, observational, monocenter study performed in the Gynecology unit of the Conception UHC in Marseille from May 2011 to October 2014. Patients over 18 years of age exhibiting an anterior vaginal and/or apical prolapse of stage ≥ 2 of the POP-Q classification resulting in functional impairment with alteration of the quality of life, without an associated posterior vaginal prolapse were included and underwent a laparoscopic anterior sacrocolpopexy (ASP). They were seen again in consultation one year from the intervention. Validated quality of life questionnaires were completed pre- and one year postoperatively. Results50 patients were included. The rate of de novo posterior vaginal prolapse was 8/50 (16 %). At one year, there was a significant improvement in terms of the SPDI-20 and SPIQ-7 (p < 0.0001) questionnaire, without significant improvement in the quality of sexual function (PISQ-12 questionnaire) (p = 0.073). ConclusionThe risk of de novo posterior vaginal prolapse at one year is low when an ASP is carried out.