Comparative study between abdominal versus laparoscopic sacral colpopexy

Abstract

This study was undertaken to compare laparoscopic and open sacral colpopexies for efficacy and safety. This prospective randomized controlled study was conducted in the Gynecologic Department of El-Shatby Maternity Hospital, University of Alexandria in Egypt. It involved 30 women selected after fulfilling the criteria of inclusion into the study with informed consent to participate in the study. All patients in this study were randomly allocated into one of the two following groups: Group A (15 patients) where laparoscopic sacrocolpopexy was done. Group B (15 patients) where abdominal (open) sacrocolpopexy was done. Demographic and hospital data, complications, and follow-up visits were reviewed. Median follow-up was 12 months in the laparoscopic and open groups. Mean operating time was significantly greater in the laparoscopic versus open group, 90 min and 70 min, respectively. Estimated blood loss (84 mL vs 156 mL) and hospital stay duration (1 vs 2 days) were significantly less in the laparoscopic group than the open group. Demographic data, other perioperative data, quality of life assessment, subjective, objective cure rates, complications and reoperation rates were non-significant. As a conclusion, laparoscopic and open sacral colpopexies have comparable clinical outcomes. Although laparoscopic sacral colpopexy requires longer operating time, hospital stay and blood loss are significantly decreased. Postoperatively overall quality of life and sexual quality showed significant improvement. The subjective cure rate was 90%, the objective cure rate (no prolapse in any compartment) was 100%. The procedure is recommended for experienced laparoscopic surgeons because of severe intraoperative complications like bladder or rectal injuries.