A Randomized Clinical Trial Comparing Dubuisson Laparoscopic Lateral Suspension with Laparoscopic Sacropexy for Pelvic Organ Prolapse: Short-Term Results

Ewelina Malanowska-Jarema; Andrzej Starczewski; Mariia Melnyk; Dulce Oliveira; Matteo Balzarro; Emanuel Rubillota

doi:10.3390/jcm13051348

A Randomized Clinical Trial Comparing Dubuisson Laparoscopic Lateral Suspension with Laparoscopic Sacropexy for Pelvic Organ Prolapse: Short-Term Results

J Clin Med. 2024 Feb 27;13(5):1348. doi: 10.3390/jcm13051348.

Authors

Ewelina Malanowska-Jarema¹, Andrzej Starczewski¹, Mariia Melnyk¹, Dulce Oliveira², Matteo Balzarro³, Emanuel Rubillota³

Affiliations

¹ Department of Gynecology, Endocrinology and Gynecologic Oncology, Pomeranian Medical University, 70-204 Szczecin, Poland.
² Institute of Science and Innovation in Mechanical and Industrial Engineering (INEGI), 4200-465 Porto, Portugal.
³ Department of Urology, Azienda Ospedaliera Universitaria Integrata Verona, 37126 Verona, Italy.

Abstract

Background: Laparoscopic sacrocolpopexy (LSC) is the gold standard for the treatment of apical prolapse, although dissection of the promontory may be challenging. Laparoscopic lateral suspension (LLS) with mesh is an alternative technique for apical repair with similar anatomical and functional outcomes, according to recent studies. The purpose of this study was to compare these operative techniques.

Methods: Women with uterine Pelvic Organ Prolapse Quantification (POP-Q) stage 2 were enrolled in this prospective study and were randomly allocated to the LLS or LSC group. At the 12-month follow-up, primary measures included both anatomical and functional outcomes. Perioperative parameters and complications were recorded.

Results: A total of 93 women were randomized, 48 in the LLS group and 45 in the LSC group, with 2 women lost to follow-up in both groups. LSC anatomic success rates were 81.82% for the apical compartment and 95.22% for the anterior compartment. LLS anatomic success rates for the apical and anterior compartments were 90% and 92.30%, respectively. The mean operative time for LLS was 160.3 min, while for LSC it was 168.3 min. The mean blood loss was 100 mL in both procedures. Conversion to laparotomy was necessary in three women. Mesh erosion was not observed in any of the cases. In terms of the complication, Clavien-Dindo grade 1 was observed in two patients in the LLS group and a complication rated grade 3b was observed in one patient in LSC group.

Conclusions: LLS is a good alternative to LSC, with promising anatomical and quality-of-life results.

Keywords: dubuisson lateral suspension; minimally invasive surgery; pelvic organ prolapse; sacrocolpopexy; uterine prolapse.

Grants and funding

This research was funded by the Independent Clinical Hospital No.1 of the Pomeranian Medical University in Szczecin. And The APC was funded by the Pomeranian Medical University in Szczecin.