Novel laparoscopic procedure provides effective, less invasive treatment of uterine prolapse
Laparoscopic anterior abdominal wall cervicopexy (LAWC) is a minimally invasive and simple procedure that appears to be safe and highly effective in the treatment of marked uterine prolapse without compromising fertility, according to a study.
To assess the safety and efficacy of LAWC, a novel minimally invasive procedure for the management of stages III and IV uterine prolapse, the procedure was performed on 39 cases with symptomatic uterine prolapse during the period from June 2012 to January 2015.
At the start of the procedure, the pouch of Douglas was obliterated through the approximation of the uterosacral ligaments with nonabsorbable suture. Then, it was completed through the anchoring of the supravaginal cervix to the anterior abdominal wall by two nonabsorbable sutures taken in good bites in the dense stroma of the supravaginal cervix.
Uterine prolapse was diagnosed as stage III in 36 women (92.3 percent) and stage IV in three. LAWC was safely performed in these patients without any intraoperative complications.
A statistically significant decrease was observed in the extent of prolapse at all pelvic organ prolapse quantification (POP-Q) points as compared with preoperative assessment at a follow-up of 3 months (p=0.000). On evaluation by the POP-Q system after 1 year, only five cases (12.8 percent) were found to have stage I uterine prolapse.
An earlier study showed that laparoscopic sacrocervicopexy was an effective option for sexually active women with pelvic organ prolapse. The success rate of the procedure was 98.4 percent for the central compartment, 94.2 percent for the anterior compartment and 99.2 percent for the posterior compartment. [JSLS 2013;17:235–244]