Laparoscopic double sacrocolpopexy : a failure for the posterior compartment?

AIM: To evaluate the anatomical and functional outcomes of laparoscopic sacrocolpopexy using an anterior and a posterior prolen mesh, for the cure of genital prolapse.

STUDY METHODS: This is a consecutive five year prospective observational study in which 80 patients presented with at least a Stage 2 apical prolapsed (Baden and Walker), with an anterior or a posterior vaginal wall prolapse, who underwent a double sacrocolpopexy. Two prolen prosthesis (Pro-swing® - Textile Hi-Tec™, Fr) were used for this technique. Pre- and post-operative data referring to prolapse quantitation (Baden and Walker classification), scores of quality of life and sexuality (French equivalent of the Pelvic Floor Distress Inventory (PFDI), Pelvic Floor Impact Questionnaire (PFIQ) and Pelvic organ prolapse-urinary Incontinence-Sexual Questionnaire (PISQ-12) were compared. Peri and postoperative complications constituted the secondary outcome measures.

RESULTS: At 2 years after surgery, all patients were accessible for evaluation. For these patients, the anatomical success rates (Stage 0 or 1) on the apical, anterior or posterior compartments were respectively 100%, 97.5% and 89.3%. On the functional level, all the scores of quality of life and sexuality were significantly improved except anorectal scores CRADI and CRAIQ.

CONCLUSIONS: This study confirms that PFC is an effective technique for the treatment of the urogenital prolapsed. On the anatomical levelresults are less good for the posterior compartment. On the functional level, our results do not plead in favour of an improvement of anorectal disorders.