- Email: [email protected]
171
Oral Presentations rejection, which required revision using a different approach. No mesh erosion was observed. Conclusion: LMSVP is an effective treatment for POP, providing support between sacro-uteral ligaments, rectovaginal septum, vaginal vault and presacral ligament; fast recovery after simultaneous repair of cystocele and rectocele in one block with one mesh, minimizing operative time and complications. FRIDAY, NOVEMBER 11, 2005 (3:51 PM–3:57 PM) Open Communications 8 —Urogynecology 171 Laparoscopic Bilateral Uterosacral Ligament Suspension for Vaginal Prolapse Agarwala N. University of Nebraska Medical Center, Omaha, Nebraska Study Objective: Review of all laparoscopic uterosacral suspension outcomes and complications for patients with pelvic prolapse. Design: Retrospective review over 2 years. The review period was between January 2003 and December 2004. Setting: University hospital. Patients: Sixty four patients with a Stage 2 or greater apical prolapse underwent bilateral uterosacral ligament suspension. Intervention: All patients had previously had a hysterectomy for various reasons. A tension free sling was also placed for patients with stress urinary incontinence. Fortytwo patients also required repair of enterocele and rectocele. All laparoscopic ports were 5 mm in size and all procedures were completed laparoscopically. Measurements and Main Results: Sixty-four patients were operated upon with a mean age of 66 (range 48 –79). The mean operating time was 93 minutes (range 65–145) including several cases of extensive adhesions, with an average hospital stay of 1.2 days (range 1–3). Average follow up was 14 months. The postoperative complication rate was 1.5% which was one right leg weakness and ambulatory difficulty after surgery. This resolved over the 6 week period with some physical therapy. Follow-up included 6 weeks, 6 month, and yearly physical examination. Two patients had recurrence (3.1%) of their prolapse requiring reoperation with laparoscopic sacral colpopexy. Conclusion: Laparoscopic uterosacral suspension is a safe and effective minimally invasive approach with no complaints of sexual dysfunction and greater than 95% patient satisfaction.
S71 FRIDAY, NOVEMBER 11, 2005 (3:57 PM– 4:03 PM) Open Communications 8 —Urogynecology 172 Multi-Center Study of a Laparoscopic Technique for Vaginal Vault Support, Interim Results Abbott K. Athena Gynecology Medical Group, Reno, Nevada Study Objective: To determine the long-term efficacy of the AVESTA procedure, a laparoscopic technique for vaginal vault support post-hysterectomy. Design: Prospective, multi-center, 60-patient study, with 24 month follow-up. Setting: Community based gynecology practices in the U.S. Patients: Twenty-four patients evaluated to date with vaginal vault prolapse using the Pelvic Organ Prolapse Quantification (POP-Q) and at least one associated symptom of vaginal pain, vaginal heaviness, anal pain or pressure, low back pain or a sense of protrusion. Intervention: Using the AVESTA procedure kit (Inlet Medical, Eden Prairie, MN) the uterosacral ligaments were invested with permanent suture using 3– 4 passes on each side, then plicated at the vaginal vault. Measurements and Main Results: Mean patient age ⫽ 48 years (range 36 –59). Mean parity - 2.4 (range 0 – 4). Patients underwent hysterectomy using a method determined by physician preference. Concomitant procedures such as cystocele, rectocele etc. repair were performed prior to AVESTA. With mean follow-up of 28 weeks (range 6 –71 weeks), the vaginal vault was well supported; all of the patients were satisfied with the procedure. There were no major and seven minor complications. Mean surgical time was 21 minutes (range 5– 45 min). Symptoms, as measured by a patient completed questionnaire containing an 11-point numeric scale demonstrated patient satisfaction with surgical results. Conclusion: AVESTA is an effective and simple laparoscopic technique that supports the vaginal vault after hysterectomy while restoring the normal vaginal axis. FRIDAY, NOVEMBER 11, 2005 (4:03 PM– 4:09 PM) Open Communications 8 —Urogynecology 173 Biosynthetic Sacrocolpopexy for Severe Pelvic Prolapse Ross J. Center for Female Continence, Salinas, California Study Objective: To test the efficacy of a dual xenogeneicsynthetic mesh system for laparoscopic sacrocolpopexy in the treatment of severe pelvic prolapse. Design: Prospective analysis of 31 consecutive cases of sacrocolpopexy. Setting: A private urogynecology clinic. Patients: Thirty-one women (ages 54 –79) with POP-Q Stage II or greater apical prolapse.
S71 FRIDAY, NOVEMBER 11, 2005 (3:57 PM– 4:03 PM) Open Communications 8 —Urogynecology 172 Multi-Center Study of a Laparoscopic Technique for Vaginal Vault Support, Interim Results Abbott K. Athena Gynecology Medical Group, Reno, Nevada Study Objective: To determine the long-term efficacy of the AVESTA procedure, a laparoscopic technique for vaginal vault support post-hysterectomy. Design: Prospective, multi-center, 60-patient study, with 24 month follow-up. Setting: Community based gynecology practices in the U.S. Patients: Twenty-four patients evaluated to date with vaginal vault prolapse using the Pelvic Organ Prolapse Quantification (POP-Q) and at least one associated symptom of vaginal pain, vaginal heaviness, anal pain or pressure, low back pain or a sense of protrusion. Intervention: Using the AVESTA procedure kit (Inlet Medical, Eden Prairie, MN) the uterosacral ligaments were invested with permanent suture using 3– 4 passes on each side, then plicated at the vaginal vault. Measurements and Main Results: Mean patient age ⫽ 48 years (range 36 –59). Mean parity - 2.4 (range 0 – 4). Patients underwent hysterectomy using a method determined by physician preference. Concomitant procedures such as cystocele, rectocele etc. repair were performed prior to AVESTA. With mean follow-up of 28 weeks (range 6 –71 weeks), the vaginal vault was well supported; all of the patients were satisfied with the procedure. There were no major and seven minor complications. Mean surgical time was 21 minutes (range 5– 45 min). Symptoms, as measured by a patient completed questionnaire containing an 11-point numeric scale demonstrated patient satisfaction with surgical results. Conclusion: AVESTA is an effective and simple laparoscopic technique that supports the vaginal vault after hysterectomy while restoring the normal vaginal axis. FRIDAY, NOVEMBER 11, 2005 (4:03 PM– 4:09 PM) Open Communications 8 —Urogynecology 173 Biosynthetic Sacrocolpopexy for Severe Pelvic Prolapse Ross J. Center for Female Continence, Salinas, California Study Objective: To test the efficacy of a dual xenogeneicsynthetic mesh system for laparoscopic sacrocolpopexy in the treatment of severe pelvic prolapse. Design: Prospective analysis of 31 consecutive cases of sacrocolpopexy. Setting: A private urogynecology clinic. Patients: Thirty-one women (ages 54 –79) with POP-Q Stage II or greater apical prolapse.