Recurrent Pelvic Organ Prolapse after Sacrocolpopexy—A Surgical Challenge
<b>Background</b>: Repeat sacrocolpopexy (reSCP) for recurrent pelvic organ prolapse (POP) is a rare and complex condition with little understanding of how to manage. Most authors recommend complete reSCP regardless of the underlying cause of the failure. This retrospective cohort study...
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-03-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/13/6/1613 |
| _version_ | 1797240560107388928 |
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| author | Andreas Martin Studer Ivo Faehnle-Schiegg Janine Frey Simone Aichner Christine Brambs Corina Christmann-Schmid |
| author_facet | Andreas Martin Studer Ivo Faehnle-Schiegg Janine Frey Simone Aichner Christine Brambs Corina Christmann-Schmid |
| author_sort | Andreas Martin Studer |
| collection | DOAJ |
| description | <b>Background</b>: Repeat sacrocolpopexy (reSCP) for recurrent pelvic organ prolapse (POP) is a rare and complex condition with little understanding of how to manage. Most authors recommend complete reSCP regardless of the underlying cause of the failure. This retrospective cohort study presents our management workflow and how to systematically approach this challenging situation. <b>Methods</b>: From 2017 to 2021, we analyzed all women undergoing surgery for recurrent POP after sacrocolpopexy at our tertiary referral hospital at the department of urogynecology. Preoperatively, all women underwent a structured work-up consisting of answering the validated German female pelvic floor questionnaires, a clinical examination utilizing the POP-Q staging system according to the International Continence Society (ICS), and a pelvic floor ultrasound. The surgical management was based on the preoperative findings and was adapted individually during surgery if indicated according to the estimated underlying problem for recurrence. <b>Results</b>: In total, 377 women underwent a primary laparoscopic sacrocolpopexy. However, ten women presented with a symptomatic recurrent prolapse requiring further surgical intervention. A reSCP was performed in eight women, including two with additional laparoscopic paravaginal repair to correct the displaced mesh placement at initial surgery. A vaginal correction was indicated in two women with an isolated posterior compartment prolapse. The analysis demonstrates that reSCP has a low intraoperative complication rate and high subjective and objective success rates. <b>Conclusions</b>: We could demonstrate that individualized reSCP after initial SCP is a challenging yet feasible and safe treatment option, but there may be suitable alternatives. If women undergo pre- and intraoperative standardized problem-oriented examinations, we can often identify the cause of the recurrent prolapse. Tailored surgery must be subsequently performed. |
| first_indexed | 2024-04-24T18:09:22Z |
| format | Article |
| id | doaj.art-926e56aa1393411ebab1df1e969648cf |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-04-24T18:09:22Z |
| publishDate | 2024-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-926e56aa1393411ebab1df1e969648cf2024-03-27T13:47:50ZengMDPI AGJournal of Clinical Medicine2077-03832024-03-01136161310.3390/jcm13061613Recurrent Pelvic Organ Prolapse after Sacrocolpopexy—A Surgical ChallengeAndreas Martin Studer0Ivo Faehnle-Schiegg1Janine Frey2Simone Aichner3Christine Brambs4Corina Christmann-Schmid5Department of Urogynecology, Cantonal Hospital of Lucerne, Spitalstrasse, 6000 Lucerne, SwitzerlandDepartment of Urogynecology, Cantonal Hospital of Lucerne, Spitalstrasse, 6000 Lucerne, SwitzerlandDepartment of Urogynecology, Cantonal Hospital of Lucerne, Spitalstrasse, 6000 Lucerne, SwitzerlandDepartment of Urogynecology, Cantonal Hospital of Lucerne, Spitalstrasse, 6000 Lucerne, SwitzerlandDepartment of Urogynecology, Cantonal Hospital of Lucerne, Spitalstrasse, 6000 Lucerne, SwitzerlandDepartment of Urogynecology, Cantonal Hospital of Lucerne, Spitalstrasse, 6000 Lucerne, Switzerland<b>Background</b>: Repeat sacrocolpopexy (reSCP) for recurrent pelvic organ prolapse (POP) is a rare and complex condition with little understanding of how to manage. Most authors recommend complete reSCP regardless of the underlying cause of the failure. This retrospective cohort study presents our management workflow and how to systematically approach this challenging situation. <b>Methods</b>: From 2017 to 2021, we analyzed all women undergoing surgery for recurrent POP after sacrocolpopexy at our tertiary referral hospital at the department of urogynecology. Preoperatively, all women underwent a structured work-up consisting of answering the validated German female pelvic floor questionnaires, a clinical examination utilizing the POP-Q staging system according to the International Continence Society (ICS), and a pelvic floor ultrasound. The surgical management was based on the preoperative findings and was adapted individually during surgery if indicated according to the estimated underlying problem for recurrence. <b>Results</b>: In total, 377 women underwent a primary laparoscopic sacrocolpopexy. However, ten women presented with a symptomatic recurrent prolapse requiring further surgical intervention. A reSCP was performed in eight women, including two with additional laparoscopic paravaginal repair to correct the displaced mesh placement at initial surgery. A vaginal correction was indicated in two women with an isolated posterior compartment prolapse. The analysis demonstrates that reSCP has a low intraoperative complication rate and high subjective and objective success rates. <b>Conclusions</b>: We could demonstrate that individualized reSCP after initial SCP is a challenging yet feasible and safe treatment option, but there may be suitable alternatives. If women undergo pre- and intraoperative standardized problem-oriented examinations, we can often identify the cause of the recurrent prolapse. Tailored surgery must be subsequently performed.https://www.mdpi.com/2077-0383/13/6/1613recurrent POPpelvic organ prolapserepeat sacrocolpopexylaparoscopic sacrocolpopexysacrocolpopexy |
| spellingShingle | Andreas Martin Studer Ivo Faehnle-Schiegg Janine Frey Simone Aichner Christine Brambs Corina Christmann-Schmid Recurrent Pelvic Organ Prolapse after Sacrocolpopexy—A Surgical Challenge Journal of Clinical Medicine recurrent POP pelvic organ prolapse repeat sacrocolpopexy laparoscopic sacrocolpopexy sacrocolpopexy |
| title | Recurrent Pelvic Organ Prolapse after Sacrocolpopexy—A Surgical Challenge |
| title_full | Recurrent Pelvic Organ Prolapse after Sacrocolpopexy—A Surgical Challenge |
| title_fullStr | Recurrent Pelvic Organ Prolapse after Sacrocolpopexy—A Surgical Challenge |
| title_full_unstemmed | Recurrent Pelvic Organ Prolapse after Sacrocolpopexy—A Surgical Challenge |
| title_short | Recurrent Pelvic Organ Prolapse after Sacrocolpopexy—A Surgical Challenge |
| title_sort | recurrent pelvic organ prolapse after sacrocolpopexy a surgical challenge |
| topic | recurrent POP pelvic organ prolapse repeat sacrocolpopexy laparoscopic sacrocolpopexy sacrocolpopexy |
| url | https://www.mdpi.com/2077-0383/13/6/1613 |
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