Standardizing abdominal sacrocolpopexy for the treatment of apical prolapse: One year on.

Abstract

To determine the safety and efficacy of a standardized bilateral abdominal sacrocolpopexy using polyvinylidene fluoride mesh 1-year post-operatively. In a retrospective observational study of women undergoing bilateral abdominal sacrocolpo/cervicopexy between July 2013 and October 2016 at the Norfolk and Norwich University Hospital, Norwich, UK, patients were assessed 1 year post-operatively using the International Consultation on Incontinence Questionnaire-Vaginal Symptoms (ICIQ-VS). The study involved 100 women, 93 of whom were followed up 1year post-operatively. The primary outcome was apical prolapse rate, of which there were none. Eight women had anterior and four had posterior wall prolapses; four women required vaginal repairs. Eleven women complained of urinary stress incontinence (six worsening and five de novo) and five had subsequent tension-free vaginal tape procedures. One woman had urethral pain and one had mesh exposure into the vagina. Pre-operatively, mean ICIQ-VS score was 27.87 (standard deviation [SD] 6.8), and at 1year post-operatively it was 5.82 (SD 3.8). Impact on quality of life score dropped by 83.4%, from 8.35 (SD 2.1) to 1.39 (SD 1.1). The modified technique used in the present study retained the advantages of traditional sacrocolpopexy, but required smaller volumes of mesh. We found it to be safe and effective with excellent patient satisfaction at 1year, and providing a promising treatment option for patients suffering from apical prolapse.