[LSC (LAPAROSCOPIC SACROCOLPOPEXY) VERSUS UPHOLD TYPE TVM: A CASE CONTROL STUDY].

Abstract

(Objective) The comparative analysis of post-surgery condition of lower urinary tract symptoms of LSC and Uphold-type TVM. (Methods) Since August 2015, our hospital introduced LSC and launched Uphold-type TVM in May 2017. 25 cases were examined by December 2017. In comparison with 37 cases of LSC conducted simultaneously, OABSS, IPSS, ICIQ-SF as well as uroflowmetry and residual urine measurement were performed with focus on perioperative complications and postoperative (3 months) lower urinary tract symptoms. As can be observed from the patient background, the average age of subject patients were close to 77 years old for TVM group, 70 years old for LSC group. LSC group showed a tendency to be observed among younger patients. (Result) In Stage II of Pelvic organ prolapse quantification (POP-Q) most of the mild cases (8 cases in TVM group and 3 cases in LSC group) existied. The type of pelvic organ prolapse (most protruding part) was bladder. Many cystoceles in the TVM group (15 cases in the TVM group and 10 cases in the LSC group) were observed. The average operation time was 115 minutes in the TVM group and 214 minutes in the LSC group which was longer. The average bleeding amount was 54 ml in the TVM group and 10 ml in the LSC group, which was quite small. For the intraoperative complication, in 2 cases bleeding volume 100 ml or more were observed in the TVM group. Bladder injury was found in 1 case. (Conclusion) Regarding postoperative complications, one case of vaginal erosion in TVM group, one case of port suture failure in LSC group, one case of de novo OAB were observed respectively. OABSS, total urinary urgency, IPSS, residual urine were improved in both groups. Both types of surgery are expected to improve lower urinary symptoms and considered to be a useful tool for treatment of pelvic organ prolapse.