Int Urogynecol J (2018) 29:453 DOI 10.1007/s00192-017-3490-5 COMMENTARY Commentary on: Laparoscopic sacrocolpopexy compared with open abdominal sacrocolpopexy for vault prolapse repair: a randomised controlled trial Alexandra Mowat Received: 12 September 2017 /Accepted: 12 September 2017 /Published online: 13 October 2017 The International Urogynecological Association 2017 This multicentre randomised controlled trial (RCT) compared significantly different between the two groups. In conclu- laparoscopic and open sacrocolpopexy in 74 women with sion, this study adds to the evidence that subjective and symptomatic vault prolapse. Most previous studies have objective outcomes are similar between open and laparo- found that the laparoscopic and open approaches have similar scopic sacrocolpopexy, with the laparoscopic approach having some preoperative advantages. anatomical outcomes but that the laparoscopic approach has the advantages of less blood loss and shorter hospital stay [1–4]. However, one recently published RCT found that the open approach has an anatomical advantage in the anterior References compartment at 3 years . The primary outcome in the pres- ent study was disease-specific quality of life measured using 1. Coolen AWM, van Oudheusden AMJ, Mol BWJ, van Eijndhoven the Urinary Distress Inventory (UDI) at 12 months. Secondary HWF, Roovers JWR, Bongers MY. Laparoscopic sacrocolpopexy outcomes included anatomical outcomes at 12 months. There compared with open abdominal sacrocolpopexy for vault prolapse repair: a randomised controlled trial. Int Urogynecol J. 2017. https:// was adequate description of randomization and concealment, 10.1007/s00192-017-3296-5. but there was a 14% attrition rate and participant or assessor 2. Freeman RM, Pantazis K, Thomson A, Frappell J, Bombieri L, blinding was not possible due to the nature of the procedures Moran P, et al. A randomised controlled trial of abdominal versus being compared. laparoscopic sacrocolpopexy for the treatment of post-hysterectomy vaginal vault prolapse: LAS study. Int Urogynecol J. 2012;24(3): At 12 months both groups showed significant improve- 377–84. ment in their UDI scores compared with before surgery, but 3. Paraiso MF, Walters MD, Rackley RR, Melek S, Hugney C. the changes were not significantly different between the two Laparoscopic and abdominal sacral colpopexies: a comparative co- groups. Around 70% of women in both groups rated their hort study. Am J Obstet Gynecol. 2005;192(5):1752–8. outcome according to the Patient Global Impression of 4. Klauschie JL, Suozzi BA, O’Brien MM, McBride AWA. comparison of laparoscopic and abdominal sacral colpopexy: objective outcome Improvement (PGI-I) as either Bmuch better^ or Bvery much and perioperative differences. Int Urogynecol J Pelvic Floor better^. There was significantly less blood loss (86 ml vs. Dysfunct. 2009;20(3):273–9. 200 ml, p < 0.0001) and shorter hospital stay (2 day vs. 4 days, 5. Costantini E, Mearini L, Lazzeri M, Bini V, Nunzi E, di Biase M, p < 0.01) in the laparoscopic group. POP-Q scores, compli- et al. Laparoscopic versus abdominal sacrocolpopexy: a randomized, cations, operating times and reoperation rates were not controlled trial. J Urol. 2016;196(1):159–65. * Alexandra Mowat firstname.lastname@example.org Greenslopes Obstetrics and Gynaecology, Brisbane, Australia
International Urogynecology Journal – Springer Journals
Published: Oct 13, 2017
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