The Assessment of Quality-of-Life after Total Laparoscopic Sacrocolpopexy with Two Separate Meshes

Abstract

Study Objective: To assess the change of the quality-of-life after total laparoscopic sacrocolpopexy with two separate meshes by using the questionnaires: PFDI-SF20, P-QOL, and ICIQ-SF. Design: Retrospective study. Setting: Hospital in affiliation with Nippon Medical School. Patients: Women (ages 45-73yrs) presenting pelvic organ prolapse. Intervention: Total laparoscopic sacrocolpopexy with two separate meshes along the anterior and posterior vaginal walls with/without supercervical hysterectomy and bilateral salphingoophorectomy. Measurements and Main Results: 30 cases of this surgery were performed in our hospital. The mean operation time and total blood loss for the latest ten cases is 211mins and 99g. To assess the change of the QOL after surgery, 11 out of the 30 patients completed the following questionnaire: PFDI-SF20, P-QOL, ICIQ-SF before operation and three months afte surgery. The results are that PFDI-SF20 score is 76.1 vs 31.6 at before and after surgery (POPDI-6: 35.2 vs 5.6, CARDI-8: 13.0 vs 7.9, UDI-6: 27.8 vs 17.9). P-QOL is composed of nine domains. The results of each domain are that general health perceptions 25.0 vs 26.5, prolapsed impact: 66.7 vs 18.1, role limitations:45.4 vs 22.6, physical limitations 49.9 vs 22.6, social limitations: 33.3 vs 15.1, personal relationships: 38.7 vs 23.5, emotions 47.4 vs 32.2, sleep/energy: 27.2 vs 18.1, and severity measures: 46.1 vs 18.9. The score of ICIQ-SF is 5.1 vs 5.7. Conclusion: Total laparoscopic sacrocolpopexy improves the QOL of POP patients on PFDI-SF and P-QOL, but did not on ICIQ-SF. In other words, this surgery can turn the structure of pelvic organ back to normal, but does not seem to affect the voiding mechanism. Total laparoscopic sacrocolpopexy is less invasive surgry and provide the improved QOL on the POP patients.