Hypothesis / aims of study
Laparoscopic sacrocolpopexy is one of the management option of pelvic organ prolapse (POP) [1]. Several studies have been conducted to assess patient satisfaction and impact on quality of life. However, many of these studies had limitations, such as small sample sizes and short follow-up periods.
The goal of this study is to assess patient satisfaction and quality of life including sexual activity, bowel and urinary symptoms after laparoscopic sacrocolpopexy.
Study design, materials and methods
It is a 20-years uni-centric retrospective cohort study including all patients who underwent laparoscopic sacrocolpopexy with double anteroposterior mesh, performed by three experienced surgeons in urogynecology, between 2003 and 2024.Data was collected from the medical records reviewed retrospectively, and a phone call interview was conducted in 2025 to evaluate the secondary and the patient reported outcomes in POP surgeries
Analyzed parameters were: the presence of LUTS (Stress urinary incontinence SUI, urgency) and digestive symptoms (constipation), the recurrence of prolapse, the need for a subsequent tape (TOT), assessment of secondary and the patient reported outcomes based on PGI scale (patient global impression) and PFIQ-7 score (Pelvic floor impact questionnaire- 7).
Results
Two hundred thirty-three patients underwent laparoscopic sacrocolpopexy (LSC) between 2003 and 2024, of whom 134 were included in the study (58%). The remaining 42% were excluded due to refusal to participate (7%), didn’t respond to the call (16%), being unreachable (15%), or deceased (4%). The mean time for follow-up was 6 ±5 years ranging from 1 to 21 years.
The mean age was 68 years, and 93% were postmenopausal. At the time of follow-up,22% had stress urinary incontinence, 22 % had urgency, 13% had constipation, and 10% reported subjective recurrence of prolapse that remains less than grade 2 without bothersome symptoms. The mean PFIQ-7 score was 11.01 and the majority had a score of zero. The PFIQ-7 was higher in patients who didn’t benefit from TOT, but the results did not reach statistical significance. Based on PGI scale after the surgery, the majority reported significant improvement of urinary symptoms and prolapse and no alteration of gastrointestinal symptoms. 16% required a tape simultaneously or postoperatively in a second intervention. Only 33% were sexually active, among those 7% experienced dyspareunia. The majority are sexually satisfied. The satisfaction rate was 89%, as represented by patients' willingness to recommend the surgery to their friends.
Interpretation of results
This is a long-term follow-up study with a mean duration of 6 years,very few similar studies are available in the literature. All patients with preoperative SUI were offered the option to benefit from simultaneous TOT. 22% experienced SUI and 22% urgency; however, these symptoms were bearable, did not affect their daily activities or quality of life. and they did not seek further consultation. Almost all patients with subjective recurrent POP were asymptomatic and had a grade less than two. The low mean PFIQ-7 score, positive PGI scale, and high satisfaction responses indicate that our patients had a very good quality of life. [2-3]