Skip to main content

Advertisement

SpringerLink
Log in

Laparoscopic management of genital prolapse

  • General Gynecology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Introduction

Genital prolapse is one of the most common indications for gynaecological surgery. Surgery is performed traditionally via abdominal, vaginal and laparoscopic approaches.

Methods

A MEDLINE computer search was performed to explore the recent evidence behind laparoscopic surgery for female pelvic organ prolapse.

Results

Advances in minimal access surgery have led to an increase in adoption of laparoscopic techniques. Current evidence supports the use of laparoscopy for sacrocolpopexy and colposuspension as an alternative to open surgery. However, the introduction of less invasive midurethral sling procedures for stress incontinence has reserved laparoscopic colposuspension for special indications. The scientific evidence regarding uterosacral suspension procedures and paravaginal and vaginal prolapse repairs are sparse.

Conclusion

The current evidence supports the outcome of laparoscopic sacrocolpopexy as an alternative to open surgery. Further studies are required on the long-term efficiency in laparoscopic paravaginal repair and vaginal wall prolapse.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Baden WF, Walker T (1992) Fundamentals, symptoms and classification. In: Baden WF, Walker T (eds) Surgical repair of vaginal defects. JB Lippincott Co, Philadelphia, pp 9–23

    Google Scholar 

  2. Albo M, Dupont Mc, Raz S (1996) Transvaginal correction of pelvic prolapse. J Endourology 10(3):231–239

    Article  CAS  Google Scholar 

  3. Cervigni M, Natale F (2001) The use of synthetics in the treatment of pelvic organ prolapse. Curr Opin Urol 11:429–435

    Article  PubMed  CAS  Google Scholar 

  4. Swift SE (2000) The distribution of pelvic organ support in a population of female subjects seen for routine gynaecologic health care. Am J Obstet Gynecol 183(2):277–285

    Article  PubMed  CAS  Google Scholar 

  5. Samuelsson EC, Victor AFT, Tibblin, Svardsudd KF (1999) Signs of genital prolapse in a Sweddish population of women 20 to 59 years of age and possible related factors. Am J Obstet Gynecol 180(2 Pt 1):299–305

    Article  PubMed  CAS  Google Scholar 

  6. Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL (1997) Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 89(4):501–506

    Article  PubMed  CAS  Google Scholar 

  7. Miklos JR, Moore RD, Khli N (2002) Laparoscopic surgery for pelvic support defects. Curr Opin Obstet Gynecol 14:387–395

    Article  PubMed  Google Scholar 

  8. De Lancey JO (1992) Anatomic aspects of vaginal eversion after hysterectomy. Am J Obstet Gynecol 166:1717–1728

    Google Scholar 

  9. Nicols DH, Malley PS, Randall CL (1970) Significance of restoration of normal vaginal depth and axis. Obstet.Gynaecol. 26:251–256

    Google Scholar 

  10. Thompson JD (1996) Surgical correction of defects in pelvic support. In: Rock JA, Thompson JD (eds) TeLinde’s operative gynaecology. Lippincott-Raven, Philadelphia, p P952

    Google Scholar 

  11. Domy JM (1989) Treatment of vaginal vault prolapse. Neth J Surg 41:152–155

    Google Scholar 

  12. Paraiso MR, Walters MD (2005) Laparoscopic surgery for stress urinary incontinence and pelvic organ prolapse. Clinical Obstet Gynecol 48(3):724–736

    Article  Google Scholar 

  13. Richardson AC (1995) The anatomic defects in rectocele and enterocele. J Pelvic Surg 1:214–221

    Google Scholar 

  14. Ross JW (1997) Apical vault repair, the cornerstone of pelvic floor reconstruction. Int Urogynecol J 8:146–152

    Article  CAS  Google Scholar 

  15. Ross JW (1997) Techniques of laparoscopic repair of total vault eversion after hysterectomy. J Am Assoc Gynecol Laparosc 4:173–183

    Article  PubMed  CAS  Google Scholar 

  16. Miklos JR, Kohli N, Lucente V, Saye WB (1998) Site specific fascial defects in the diagnosis and surgical management of enterocele. Am J Obstet Gynecol 179:1418–1423

    Article  PubMed  CAS  Google Scholar 

  17. Carter JE, Winter M, Mendehlsohn S et al (2001) Vaginal vault suspension and enterocele repair by Richardson–Saye laparoscopic technique: description of training technique and results. J Soc Laproend Surg 5:29–36

    CAS  Google Scholar 

  18. Buller JL, Thompson JR, Cundiff GW et al (2001) Utersacral ligament: description of anatomic relationships to optimize surgical safety. Obstet Gynecol 97:873–879

    Article  PubMed  CAS  Google Scholar 

  19. Wu MP (1997) Laparoscopic uterine suspension for the treatment of uterovaginal prolapse. Int J Gynecol Obstet 59:259–260

    Article  CAS  Google Scholar 

  20. Maher CF, Carey MP, Murray CJ (2001) Laparoscopic suture hysteropexy for uterine prolapse. Obstet Gynecol 97:1010–1014

    Article  PubMed  CAS  Google Scholar 

  21. Lyons TL (1995) Minimally invasive treatment of urinary stress incontinence and laparoscopoically direct repair of pelvic floor defects. Clin Obstet Gynecol 38:380–391

    Article  PubMed  CAS  Google Scholar 

  22. Koninckx PR, Poppe W, Deprest J (1995) Carbon dioxide laser for laparoscopic enterocele repair. J Am Assoc Gyencol Laparoscop 2:181–185

    Article  CAS  Google Scholar 

  23. Uccella S, Ghezzi F, Bergamini V, Serati M, Cromi A, Franchi M, Bolis P (2007) Laparoscopic uterosacral ligaments plication for the treatment of uterine prolapse. Arch Gynecol Obstet 276(3):225–229

    Article  PubMed  Google Scholar 

  24. Diwan A, Rardin CR, Strohsnitter WC, Weld A, Rosenblatt P, Kohli N (2006) Laparoscopic uterosacral ligament uterine suspension compared with vaginal hysterectomy with vaginal vault suspension for uterovaginal prolapse. Int Urogynecol J Pelvic Floor Dysfunct 17(1):79–83

    Article  PubMed  Google Scholar 

  25. Price N, Jackson SR (2009) Advances in laparoscopic techniques in pelvic reconstructive surgery for prolapse and incontinence. Maturitas 62(3):276–280

    Article  PubMed  Google Scholar 

  26. Undiff GW, Harris RL, Coates K et al (1997) Abdominal sacral colpoperineopexy: a new approach for correction of posterior compertment defects and perineal descent associated with vaginal vault prolapse. Am J Obstet Gynecol 177:1345–1355

    Article  Google Scholar 

  27. Baker KR, Beresford JM, Campbell C (1990) Colposacropexy with prolene mesh. Surg Gynecol Obstet 171:51–54

    PubMed  CAS  Google Scholar 

  28. Creighton SM, Stanton SL (1991) The surgical management of vaginal vault prolapse. Br J Obstet Gynaecol 98:1150–1154

    Article  PubMed  CAS  Google Scholar 

  29. Valaitas SR, Stanton SL (1994) Sacrocolpopexy: a retrospective study of a clinician’s experience. Br J Obstet Gynaecol 178:283–287

    Google Scholar 

  30. De Vries MJ, van Dessel TH, Drogendijk AC et al (1995) Short-term results and long-term patients’ appraisal of abdominal colposacropexy for treatment of genital and vaginal vault prolapse. Eur J Obstet Gynecol Reprod Biol 59:35–38

    Article  PubMed  Google Scholar 

  31. Nezhat CH, Nezhat F, Nezhat C (1994) Laparoscopic sacral colpopexy for vaginal vault prolapse. Obstet Gynecol 4:381–383

    Google Scholar 

  32. Seraccholi R, Hourcabie JA, Vianello F et al (2004) Laparoscopic treatment of pelvic floor defects in women of reproductive age. J Am Assoc Gynecol Laparosc 11:332–335

    Article  Google Scholar 

  33. Jia X, Glazener C, Mowatt G, Jenkinson D, Fraser C, Bain C, Burr J (2010) Systematic review of the efficacy and safety of using mesh in surgery for uterine or vaginal vault prolapse. Int Urogynecol J Pelvic Floor Dysfunct 21(11):1413–1431

    Google Scholar 

  34. Richardson AC, Lyen JB, Williams NLA (1976) New look at pelvic relaxation. Am J Obstet Gynaecol 126:568–573

    CAS  Google Scholar 

  35. Miklos JR, Kohli N (1998) “Paravaginal plus” Burch procedure: a laparoscopic approach. J Pelvic Surg 4:297–302

    Google Scholar 

  36. Richardson CA (1990) How to correct prolapse paravaginally. Contemp Obstet Gynaecol 35:100–115

    Google Scholar 

  37. Webber AM, Walters MD (1997) Anterior vaginal prolapse: review of anatomy and techniques of surgical repair. Obstet Gynaecol 89(2):311–318

    Article  Google Scholar 

  38. Bruce RG, El-Galley RES, Galloway NTM (1999) Paravaginal defect repair in the treatment of female urinary incontinence and cystocele. Urol 54:647–651

    Article  PubMed  CAS  Google Scholar 

  39. Youngblood JP (1993) Paravaginal repair for cystourethrocele. Obstet Gynaecol 36(4):960–966

    CAS  Google Scholar 

  40. Baden WF, Walker T (1992) Surgical repair of vaginal defects. J.B. Lippencott, Philadelphia, pp 1–7

    Google Scholar 

  41. Paraiso MFR, Falcone T (2000) Laparscopic surgery for genuine stress urinary incontinence and pelvic organ prolapse. In: Walters MD, Karam MM (eds) Clinical urogynecology, 2nd edn. CV Mosby, St Louis, pp 197–209

    Google Scholar 

  42. Lyons TL, Winer WK (1997) Laparoscopic rectocele repair using polyglactin mesh. J Am Assoc Gynecol Laparosc 4:381–384

    Article  PubMed  CAS  Google Scholar 

  43. Liu CY (1994) Laparoscopic treatment of genuine urinary stress incontinence. Clin Obstet Gynecol 8:789–798

    CAS  Google Scholar 

  44. Lee CL, Yen CF, Wang CJ et al (2001) Extraperitoneal approach to laparoscopic Burch colposuspension. J Am Assoc Gynecol Laparosc 8:374–377

    Article  PubMed  CAS  Google Scholar 

  45. Burton G (1999) A five year prospective randomized urodynamics study comparing open and laparoscopic colposuspension [Abstract]. Neurourol Urodyn 18

  46. Carey M, Rosamilia A, Maher C et al (2000) Laparoscopic versus open colposuspension: a prospective multicentre randomized single-blind [Abstract 8]. Neurourol Urodyn 19:389

    Google Scholar 

  47. Fatthy H, El Hao M, Samaha I et al (2001) Modified Burch colposuspension: laparoscopy vs laparotomy. J Am Assoc Gynecol Laparosc 8:99–106

    Article  PubMed  CAS  Google Scholar 

  48. Su TH, Wang KG, Hsu CY et al (1997) Prospective comparison of laparoscopic and traditional colposuspensions in the treatment of genuine stress incontinence. Acta Obstet Gynecol Scand 76:576–582

    Article  PubMed  CAS  Google Scholar 

  49. Summitt RL, Lucente VL, Karram MM et al (2000) Randomised comparison of laparoscopic and transabdominal Burch urethropexy for the treatment of genuine stress incontinence [Abstract]. Obstet Gynecol 95(Suppl 1):S2

    Article  Google Scholar 

  50. Ustun Y, Engin-U¨stun Y, Gungor M et al (2003) Tension-free vaginal tape compared with laparoscopic Burch urethropexy. J Am Assoc Gynecol Laparosc 10:386–389

    Article  PubMed  Google Scholar 

  51. Paraiso MF, Walters MD, Karram MM et al (2004) Laparoscopic Burch colposuspension versus tension-free vaginal tape: a randomized clinical trial. Obstet Gynecol 104:1249–1258

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, James Paget University Hospital, Great Yarmouth, Norfolk, NR31 6LA, UK

    Montasser A. Mahran & Nicholas Oligbo

  2. Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka

    R. P. Herath

  3. Department of Obstetrics and Gynaecology, The Ipswich General Hospital NHS Trust, Suffolk, UK

    Ayman T. Sayed

Authors
  1. Montasser A. Mahran
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. R. P. Herath
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ayman T. Sayed
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Nicholas Oligbo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Montasser A. Mahran.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mahran, M.A., Herath, R.P., Sayed, A.T. et al. Laparoscopic management of genital prolapse. Arch Gynecol Obstet 283, 1015–1020 (2011). https://doi.org/10.1007/s00404-010-1822-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-010-1822-5

Keywords

Search

Navigation