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Research paper
Published online: 2023-01-13
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Effects of unilateral apical sling and laparoscopic sacrocolpopexy on the outcome in women with apical prolapse: randomised trial

Botagoz Aitbayeva1, Serik Iskakov1, Elena Lushchaeva2, Galymzhan Toktarbekov2, Kamilla Kenbayeva2
DOI: 10.5603/GP.a2023.002
Affiliations
  1. Department of Obstetrics and Gynecology No. 2, NJSC „Astana Medical University”, Astana, Kazakhstan, Kazakhstan
  2. Clinical Academic Department of Women’s Health, University Medical Center, Astana, Kazakhstan, Kazakhstan

open access

Ahead of Print
ORIGINAL PAPERS Obstetrics
Published online: 2023-01-13

Abstract

Objectives: The purpose of this study was to compare the use of unilateral apical sling versus laparoscopic sacrocolpopexy in the treatment of the apical form of pelvic organ prolapse in women.

Material and methods: A prospective, single-center randomized trial included 100 patients who were alternately assigned to treatment. Each patient had a ≥ III stage of apical or anterior-apical prolapse determined by the POP-Q system. 45 accepted for unilateral apical sling (UAS) and 55 accepted for laparoscopic sacrocolpopexy (LS). Data were compared by the One-way ANOVA test using IBM SPSS stats 19.

Results: Mean operating time was significantly greater in the LS group versus UAS group, 194.6 vs 42.4 minutes, respectively (p < 0.05). The amount of intraoperative bleeding was significantly higher in the UAS group, compared to the LS group (p = 0.01). Within the follow-up period, 2 patients in UAS group and 3 patients in LS group (4.4% vs 5.4%, respectively; p = 0.9) had recurrent cystocoele. HRQoL and sexual outcomes did not differ significantly between the two treatment groups.

Conclusions: Our data demonstrate the non-superiority one on each other of the two different approaches, except in terms of shorter operating time and higher intraoperative bleeding when UAS used. These findings raise questions about the need for long-term results of quality of life outcomes for women with genital prolapse, especially in resource-limited settings similar to Kazakhstan.

Abstract

Objectives: The purpose of this study was to compare the use of unilateral apical sling versus laparoscopic sacrocolpopexy in the treatment of the apical form of pelvic organ prolapse in women.

Material and methods: A prospective, single-center randomized trial included 100 patients who were alternately assigned to treatment. Each patient had a ≥ III stage of apical or anterior-apical prolapse determined by the POP-Q system. 45 accepted for unilateral apical sling (UAS) and 55 accepted for laparoscopic sacrocolpopexy (LS). Data were compared by the One-way ANOVA test using IBM SPSS stats 19.

Results: Mean operating time was significantly greater in the LS group versus UAS group, 194.6 vs 42.4 minutes, respectively (p < 0.05). The amount of intraoperative bleeding was significantly higher in the UAS group, compared to the LS group (p = 0.01). Within the follow-up period, 2 patients in UAS group and 3 patients in LS group (4.4% vs 5.4%, respectively; p = 0.9) had recurrent cystocoele. HRQoL and sexual outcomes did not differ significantly between the two treatment groups.

Conclusions: Our data demonstrate the non-superiority one on each other of the two different approaches, except in terms of shorter operating time and higher intraoperative bleeding when UAS used. These findings raise questions about the need for long-term results of quality of life outcomes for women with genital prolapse, especially in resource-limited settings similar to Kazakhstan.

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Keywords

apical prolapse; health-related quality of life; unilateral apical sling; mesh surgery

About this article
Title

Effects of unilateral apical sling and laparoscopic sacrocolpopexy on the outcome in women with apical prolapse: randomised trial

Journal

Ginekologia Polska

Issue

Ahead of Print

Article type

Research paper

Published online

2023-01-13

Page views

23

Article views/downloads

16

DOI

10.5603/GP.a2023.002

Keywords

apical prolapse
health-related quality of life
unilateral apical sling
mesh surgery

Authors

Botagoz Aitbayeva
Serik Iskakov
Elena Lushchaeva
Galymzhan Toktarbekov
Kamilla Kenbayeva

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