Evaluation of the results of laparoscopic lateral suspension operations performed in our clinic

Introduction: Pelvic organ prolapse is the descent of one or more compeonents of the vagina and uterus: the anterior wall, the posterior wall of the vagina, the uterus, or the apex of the vagina (vaginal cuff), due to muscular or ligament weakness. For women with advanced prolapse, it is increasingly recognised that adequate support of the vaginal apex is an essential component of a durable surgical repair. Laparoscopic sacrocolpopexy for apical prolapse is currently considered the gold standard, but it rarely causes vascular or nerve damage due to deep pelvic dissection. İn the recent years, laparoscopic lateral suspension without deep pelvic dissection can be used to treat apical prolapse. The aim of our study was to evaluate the results of laparoscopic lateral suspension in our clinic. Material and methods: Between January 2021 and July 2024, a total of 47 patients who had undergone a laparoscopic lateral suspension repair were included in the study. Demographic data, comorbid disease, obstetric history, degree of uterine prolapse, surgical procedure performed in conjunction with laparoscopic lateral suspension, postoperative symptoms and complications were recorded. The success rate of laparoscopic lateral suspension was evaluated after physical examination of the patients at 1, 6 and 12 months postoperatively. Results The mean age of the patients was 52.4 ± 14.6 years. Comorbidities were present in 46.8% of the patients. The most common comorbidities were hypertension (25.5%) and diabetes (21.3%). 59.6% of the patients were postmenopausal, 27.7% had undergone a hysterectomy prior to surgery and 51.1% had incontinence. In the POP-Q assessment, the grade of uterine prolapse was grade I in 2.1%, grade II in 12.8%, grade III in 53.2% and grade IV in 31.9%. The most common surgeries performed with laparoscopic lateral suspension were colporrhaphy posterior (64.1%), colporrhaphy anterior (48.7%) and total laparoscopic hysterectomy (48.7%), respectively. In the postoperative period, no mesh erosion and ClavienDindo≥III complications were observed in any patient. Two patients had incontinence and 1 patient had cystocele+incontinence at the first month examination. While cystocele+incontinence was observed in two patients at the sixth month physical examination, cystocele+incontinence was observed in only one patient at the twelfth month physical examination. In the first year, the anatomical success rate was 97.9% for anterior prolapse, 100% for posterior prolapse and 100% for apical prolapse when evaluated by compartment. Conclusion Laparoscopic lateral suspension for treating apical prolapse is a technique with optimal results regarding safety and efficacy at 1 year follow-up. Laparoscopic lateral suspension may be a good alternative to sacrocolpopexy. Key words: Pelvic organ prolapsus, apical prolapsus, laparoscopic lateral suspension, Mid term results