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Comparison of laparoscopic pectopexy with the standard laparoscopic sacropexy for apical prolapse: an exploratory randomized controlled trial

OBJECTIVE: To compare laparoscopic pectopexy with the standard laparoscopic sacropexy in women with symptomatic apical prolapse. MATERIAL AND METHODS: An interim analysis of an exploratory randomized controlled trial with the primary objective of comparing mesh fixation time and secondary objectives...

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Autores principales: Khoiwal, Kavita, Dash, Kanhu Charan, Gaurav, Amrita, Chaturvedi, Jaya
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Galenos Publishing 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10493818/
https://www.ncbi.nlm.nih.gov/pubmed/37548513
http://dx.doi.org/10.4274/jtgga.galenos.2023.2022-12-15
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author Khoiwal, Kavita
Dash, Kanhu Charan
Gaurav, Amrita
Chaturvedi, Jaya
author_facet Khoiwal, Kavita
Dash, Kanhu Charan
Gaurav, Amrita
Chaturvedi, Jaya
author_sort Khoiwal, Kavita
collection PubMed
description OBJECTIVE: To compare laparoscopic pectopexy with the standard laparoscopic sacropexy in women with symptomatic apical prolapse. MATERIAL AND METHODS: An interim analysis of an exploratory randomized controlled trial with the primary objective of comparing mesh fixation time and secondary objectives were to compare total operating time, blood loss, and intra-operative and post-operative complications. Additionally, patients completed the Prolapse Quality of Life (P-QOL) and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) questionnaires before surgery and during six months follow-up visit to evaluate the overall improvement in quality of life and sexual function. Patient Global Impression of Improvement (PGI-I) score was calculated on the 7-10(th) day post-operatively and then at six months to assess the level of improvement. RESULTS: The study included 30 patients; 15 underwent laparoscopic sacropexy, and 15 underwent laparoscopic pectopexy. Baseline characteristics were comparable in both groups. The mean duration of mesh fixation was significantly less with laparoscopic pectopexy (45.00±11.34 minutes) than laparoscopic sacropexy (54.67±9.35 minutes) (p=0.019). The total operating time and blood loss tended to be less in the pectopexy group, but not significantly so. Only one patient in the pectopexy group had a bladder injury. No patient in either group had any post-operative complications. One case in each group had a relapse of apical prolapse. All the domains of PISQ-12, P-QOL, and PGI-I scores improved significantly after both procedures. CONCLUSION: Laparoscopic pectopexy is a safe, feasible, and comfortable alternative procedure to the standard sacropexy for apical prolapse. We noted significantly less mesh fixation time and less operating time, while blood loss tended to be less with laparoscopic pectopexy than with laparoscopic sacropexy. Post-operative parameters were comparable between techniques. Both corrective techniques for prolapse improved the PGI-I, P-QOL, and PISQ-12 scores.
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spelling pubmed-104938182023-09-12 Comparison of laparoscopic pectopexy with the standard laparoscopic sacropexy for apical prolapse: an exploratory randomized controlled trial Khoiwal, Kavita Dash, Kanhu Charan Gaurav, Amrita Chaturvedi, Jaya J Turk Ger Gynecol Assoc Original Investigation OBJECTIVE: To compare laparoscopic pectopexy with the standard laparoscopic sacropexy in women with symptomatic apical prolapse. MATERIAL AND METHODS: An interim analysis of an exploratory randomized controlled trial with the primary objective of comparing mesh fixation time and secondary objectives were to compare total operating time, blood loss, and intra-operative and post-operative complications. Additionally, patients completed the Prolapse Quality of Life (P-QOL) and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) questionnaires before surgery and during six months follow-up visit to evaluate the overall improvement in quality of life and sexual function. Patient Global Impression of Improvement (PGI-I) score was calculated on the 7-10(th) day post-operatively and then at six months to assess the level of improvement. RESULTS: The study included 30 patients; 15 underwent laparoscopic sacropexy, and 15 underwent laparoscopic pectopexy. Baseline characteristics were comparable in both groups. The mean duration of mesh fixation was significantly less with laparoscopic pectopexy (45.00±11.34 minutes) than laparoscopic sacropexy (54.67±9.35 minutes) (p=0.019). The total operating time and blood loss tended to be less in the pectopexy group, but not significantly so. Only one patient in the pectopexy group had a bladder injury. No patient in either group had any post-operative complications. One case in each group had a relapse of apical prolapse. All the domains of PISQ-12, P-QOL, and PGI-I scores improved significantly after both procedures. CONCLUSION: Laparoscopic pectopexy is a safe, feasible, and comfortable alternative procedure to the standard sacropexy for apical prolapse. We noted significantly less mesh fixation time and less operating time, while blood loss tended to be less with laparoscopic pectopexy than with laparoscopic sacropexy. Post-operative parameters were comparable between techniques. Both corrective techniques for prolapse improved the PGI-I, P-QOL, and PISQ-12 scores. Galenos Publishing 2023-09 2023-09-07 /pmc/articles/PMC10493818/ /pubmed/37548513 http://dx.doi.org/10.4274/jtgga.galenos.2023.2022-12-15 Text en © Copyright 2023 by the Turkish-German Gynecological Education and Research Foundation https://creativecommons.org/licenses/by-nc-nd/4.0/Journal of the Turkish-German Gynecological Association published by Galenos Publishing House.
spellingShingle Original Investigation
Khoiwal, Kavita
Dash, Kanhu Charan
Gaurav, Amrita
Chaturvedi, Jaya
Comparison of laparoscopic pectopexy with the standard laparoscopic sacropexy for apical prolapse: an exploratory randomized controlled trial
title Comparison of laparoscopic pectopexy with the standard laparoscopic sacropexy for apical prolapse: an exploratory randomized controlled trial
title_full Comparison of laparoscopic pectopexy with the standard laparoscopic sacropexy for apical prolapse: an exploratory randomized controlled trial
title_fullStr Comparison of laparoscopic pectopexy with the standard laparoscopic sacropexy for apical prolapse: an exploratory randomized controlled trial
title_full_unstemmed Comparison of laparoscopic pectopexy with the standard laparoscopic sacropexy for apical prolapse: an exploratory randomized controlled trial
title_short Comparison of laparoscopic pectopexy with the standard laparoscopic sacropexy for apical prolapse: an exploratory randomized controlled trial
title_sort comparison of laparoscopic pectopexy with the standard laparoscopic sacropexy for apical prolapse: an exploratory randomized controlled trial
topic Original Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10493818/
https://www.ncbi.nlm.nih.gov/pubmed/37548513
http://dx.doi.org/10.4274/jtgga.galenos.2023.2022-12-15
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