Abstract
While laparoscopic sacrocolpopexy is a well-established laparoscopic procedure in the management of pelvic organ prolapse in Western countries, laparoscopic sacrocolpopexy is not widely accepted in Japan. We report four cases in which laparoscopic sacrocolpopexy was performed to treat severe pelvic organ prolapse. The patients were in the 7th and 8th decades of life. Two patients were pelvic organ prolapse quantification (POP-Q) stage III and two patients were POP-Q stage IV. Two of the four patients (# 1 and 2) had pollakisuria and stress urinary incontinence pre-operatively. While intraoperative bleeding was not excessive, the operative time tended to be prolonged, ranging from 210-313 minutes {275.25±45.68 (mean±SD) minutes}. A complication occurred in one patient (# 3). Specifically, strangulation ileus resulting from trocar site herniation occurred on post-operative day 2, for which emergent surgery was required. The anatomic recurrence rate was 25% (1 of 4). Patient # 3 had recurrent prolapse 7 months after the laparoscopic surgery and re-operation was performed. The pre-operative urinary symptoms in patient # 1 were improving. Patient # 2 was improving, but not completely. Laparoscopic sacrocolpopexy may be useful in the management of pelvic organ prolapse; however, improvement in the surgical technique is needed to decrease invasiveness and reduce the complication and recurrence rates.
