Abstract

DE LOS RIOS, José F; RESTREPO, José L  and  CASTANEDA, Juan D. Laparoscopic hysterosacropexy for uterine conservation in patients having pure apical defects: a report of 4 cases from Medellín, Colombia, during 2006. Rev Colomb Obstet Ginecol [online]. 2008, vol.59, n.1, pp.51-56. ISSN 0034-7434.

Objective: describing the laparoscopic hysterosacropexy technique and short-term results in 4 patients with apical prolapse in whom hysterectomy was contraindicated. Setting: gynecological endoscopy unit, Clínica del Prado, Medellín, Colombia. Sample: four patients with apical prolapse wishing for uterine conservation or having contraindication for hysterectomy. Methods: reviewing medical records, follow-up visits and telephone questionnaire. Main outcomes: age, indication for surgery, operating time, estimated blood loss, intra-operative complications, hospitalization time, incidence of postoperative urinary, defecatory or sexual dysfunction, developing urinary incontinence, mesh-derived complications, prolapse recurrence, subjective cure rate, objective cure rate, satisfaction, pregnancies after surgery. Results: mean age was 53 (39-71), 67 minutes mean time(60-75) spent in surgery, 30 cc mean estimated blood loss (10-50) and 15 hours mean hospitalisation time (6-24). There were no intra-operation complications. There have been no recurrences of prolapse or any evidence of urinary, defecatory or costal dysfunctions in sexually-active patients during mean follow-up period (12 months). All patients were completely satisfied with the operation result. No pregnancies have been recorded to date. Conclusions: laparoscopic hysterosacropexy could be a valid alternative in our setting for treating patients suffering apical prolapse having contraindication for hysterectomy. Further studies are needed for establishing its role in clinical practice.

Keywords : hysteropexy; laparoscopy; apical prolapse; sacropexy.

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