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Three-Year Outcomes of a Multicenter Study of Japanese-Style Laparoscopic Sacrocolpopexy

  • Tomoko Kuwata,
  • Hiromi Kashihara,
  • Chikako Kato,
  • Masami Takeyama,
  • Akane Yamaguchi,
  • Youji Moriyama,
  • Chie Nakai,
  • Kosei Miwa,
  • Hidemori Araki,
  • Masahiro Narushima,
  • Mari Yamasaki,
  • Hiromi Hirama,
  • Homare Okazoe

摘要

Introduction and Hypothesis

Laparoscopic sacrocolpopexy(LSC) is widely performed and has been reported to safe and effective. However, statistical data on this technique are unavailable. Therefore, we designed the Japanese-style LSC, a further evolution of the French-style LSC, and initiated this multicenter study to prospectively evaluate its efficacy and safety. If the Japanese-style LSC is successful, we may be able to propose a more reliable and standardized procedure.

Methods

This is a prospective study of Japanese-style LSC. The Japanese-style LSC is characterized by the dissection of the vaginal walls as distally as possible and fixation of the mesh with multiple sutures; fixation of the mesh on the promontory without traction; and closure of the peritoneum with high-level peritoneal sutures. We examined the primary (anatomical recurrence, adverse events, and quality of life) and secondary endpoints (voiding symptoms and sexual function) at 3 years postoperatively.

Results

In anatomical recurrence, 24 patients (9.2%) were ≥ stage2 in the Pelvic Organ Prolapse Quantification system at 3 years postoperatively, of which 4 (1.5%) and 20 (7.7%) were stages III and II respectively. No mesh-related complications were observed, and each questionnaire showed predominant improvement, except for sexual and evacuation functions.

Conclusions

The Japanese-style LSC demonstrated superior anatomical and functional results and we propose it to be an effective procedure.