A Real-World Study Of Laparoscopic Lateral Suspension With Mesh For Anterior And Middle Pelvic Organ Prolapse In Women

Objective: To conduct a single-center real-world study of laparoscopic lateral suspension with mesh(LLS group)versus transvaginal mesh placement for pelvic floor reconstruction(TVM group).To systematically compare the surgical outcomes,safety,and patient satisfaction between these two surgical approaches.To investigate the value of laparoscopic lateral suspension with mesh for clinical application.Methods: Patients who were hospitalized in Sichuan Provincial People’s Hospital for surgical treatment of anterior and middle pelvic organ prolapse since December 2021 were selected.By December 2022,a total of 58 patients with prolapse were included according to the inclusion and exclusion criteria,and were divided into two groups according to the patients’ preferences.28 patients were in the LLS group and 30 patients were in the TVM group.The general,preoperative and perioperative indicators of patients in both groups were counted for analysis,and patients were followed up at 1,3,6 and 12 months postoperatively.The patients’ postoperative anatomical recovery and the occurrence of complications were counted and analyzed.The PFDI-20,PFIQ-7 and PISQ-12 questionnaires were used to determine the patients’ quality of life at the preoperative and postoperative follow-ups.The PGI-C questionnaire was used at the 6-month postoperative follow-up to understand the recovery of patients’ general condition.Results: The anterior and middle pelvic corresponding POP-Q anatomical site measurements,quality of life,and sexual quality of life in both groups were significantly improved compared with those before surgery,and the difference was statistically significant(p < 0.05).The objective cure rates were 92.9% and 96.7% at 3 months postoperatively and 89.3% and 93.3% at 6 months postoperatively in the two groups,respectively.The subjective cure rates within the short-term follow-up were 100% in both groups.The operative time in the LLS group was significantly longer than that in the TVM group,and the difference was statistically significant(p< 0.05).There was no significant difference in intraoperative bleeding,postoperative catheter retention time and postoperative hospitalization time between the two groups.There was no statistically significant difference in the perioperative complications and postoperative complications between the two groups(p> 0.05).No patients in both groups recurred within the shortterm follow-up,and the overall postoperative satisfaction of patients in both groups was high.Conclusion: Laparoscopic lateral suspension with mesh with preservation of the uterus can well correct anterior and middle pelvic organ prolapse.Within the short-term follow-up,the quality of life and sexual quality of life of the patients were significantly improved,and the postoperative satisfaction of the patients was high.Therefore,it is a safe and effective surgical procedure for the treatment of uterus-preserving anterior midpelvic organ prolapse.The short-term surgical results of LLS in this study were not inferior to those of TVM,and LLS is simpler,easier and more generalizable for the surgical side of anterior and middle pelvic organ prolapse,while ensuring the same surgical results.