Vaginal prolapse surgery treatment with laparoscopic sacral colpopexy (LSC) more effective than total vaginal mesh (TVM)

Vaginal vault prolapse or female genital prolapse is bulging of the top of the vagina into the lower vagina or outside the opening of the vagina.
The condition usually occurs when the pelvic floor collapses as a result of childbirth.

The treatment based on symptoms severity (0-4 of grades) such as changes in diet and fitness, using small plastic or silicone medical device to treat weakening vagina wall, and surgery when it is associated with other problems such as urinary problems, pain, and prolapse sensation.

One of the treatment used for vaginal vault prolapse in stage 2 where is the most distal prolapse between 1 cm above and 1 cm bellow the hymen, then the surgery of total vaginal mesh (TVM) commonly used.
However, this procedure associated with higher blood loss risk, and longer catheter stays.

According to new study from Australia, compared with TVM procedure, laparoscopic sacral colpopexy (LSC) is more effective to treat vaginal vault prolapse.
Although this operating time was longer than TVM, however, according to the study authors, LSC significantly reduce blood loss and catheter stay, including return to activities of daily living.

The study authors, Dr. Christopher F. Maher from the Mater Medical Center in Brisbane, Australia, and colleagues write in their report that published in the American Journal of Obstetrics and Gynecology on February 8, 2011, “At 2 years, the laparoscopic sacral colpopexy had a higher satisfaction rate and objective success rate than the total vaginal mesh with lower perioperative morbidity and reoperation rate”, although the severity and quality of life scores almost similar both of LSC and TVM.

This findings appeared after the trial among 108 women that recruited with symptomatic stage 2 or higher vaginal prolapse and randomly assigned to LSC and TVM.

According to the findings, compared with TVM group who required reoperations (22%), LSC group only 5% need reoperations.
The success rate (defined as stage 0 or stage 1 of prolapse) is higher in LSC (77%) than TVM (42%), including satisfaction score of 87 with LSC than 79 with TVM. The satisfaction score based on symptomatic prolapse after surgery.