%0 Journal Article
%T A Comparison of Complications between Open Abdominal Sacrocolpopexy and Laparoscopic Sacrocolpopexy for the Treatment of Vault Prolapse
%A Anne-Lotte W. M. Coolen
%A Anique M. J. van Oudheusden
%A Hugo W. F. van Eijndhoven
%A Tim P. F. M. van der Heijden
%A Rutger A. Stokmans
%A Ben Willem J. Mol
%A Marlies Y. Bongers
%J Obstetrics and Gynecology International
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/528636
%X Introduction. Sacrocolpopexy is a generally applied treatment for vault prolapse which can be performed laparoscopically or by open laparotomy. Methods. Between October 2007 and December 2012, we performed a multicenter prospective cohort study in 2 university and 4 teaching hospitals in the Netherlands. We included patients with symptomatic posthysterectomy vaginal vault prolapse requiring surgical treatment, who either had abdominal or laparoscopic sacrocolpopexy. We studied surgery related morbidity, which was divided in pre-, peri-, and postoperative characteristics. Results. We studied 85 patients, of whom 42 had open abdominal and 43 laparoscopic sacrocolpopexy. In the laparoscopic sacrocolpopexy group, estimated blood loss was significantly less compared to the abdominal group: 192£¿mL (¡À126) versus 77£¿mL (¡À182), respectively ( ). Furthermore, hospital stay was significantly shorter in the laparoscopic group (4.2 days) as compared to the abdominal group (2.4 days) ( ). The overall complication rate was not significantly different ( ). However there was a significant difference in favor of the laparoscopic group in peri- and postoperative complications requiring complementary (conservative) treatment and/or extended admittance (RR 0.24 (95%-CI 0.07¨C0.80), ). Conclusion. Laparoscopic sacrocolpopexy reduces blood loss and hospital stay as compared to abdominal sacrocolpopexy and generates less procedure related morbidity. 1. Introduction The incidence of posthysterectomy vault prolapse requiring surgery has been estimated at 36 per 10,000 women years [1]. The risk increases cumulatively with years after hysterectomy and increases significantly in women whose initial hysterectomy was performed for genital prolapse [1¨C3]. In an aging population, the number of women that will seek medical help for a vaginal vault prolapse will increase due to an improved life expectancy and due to the aging population. Surgery for pelvic organ prolapse, including vaginal vault prolapse, focuses on the restoration of the normal vaginal anatomy and normal bladder and bowel function. To date, a variety of different surgical procedures to correct vaginal vault prolapse have been reported [4]. These reconstructive techniques can principally be divided into vaginal or abdominal procedures. The abdominal approach can be performed open or laparoscopically. According to a Cochrane review on the subject, abdominal sacrocolpopexy is associated with a lower rate of recurrent vault prolapse compared to the vaginal sacrospinous fixation [5]. Success rates of abdominal sacrocolpopexy
%U http://www.hindawi.com/journals/ogi/2013/528636/