Our Summary

This research paper examines the effectiveness and impact on quality of life between two types of surgeries used to treat pelvic organ prolapse: laparoscopic total and/or supracervical hysterectomy (LTH/LSCH) with laparoscopic sacrocolpopexy (LSC) and minimally invasive sacrohysteropexy (LSH).

The researchers analyzed multiple studies on this topic to get a comprehensive view of the issue. Their findings show that combining LTH/LSCH with LSH is more effective in treating pelvic organ prolapse, particularly in the upper (apical) and front (anterior) areas of the pelvis. This combined approach also leads to better patient satisfaction after surgery.

Importantly, they found no significant differences between the two types of surgeries when it comes to complications during or after the procedure, sexual dysfunction, and stress urinary incontinence after surgery.

Moreover, the combined LTH/LSCH with LSC method was associated with shorter surgery time and hospital stay. There were no significant differences in the rates of recurrence and need for reoperation between the two types of surgeries.

The use of mesh, which is often a concern due to potential complications, was not associated with a higher rate of issues in surgeries that also involved a hysterectomy.

The researchers recommend thorough conversations with patients who wish to preserve their uterus before the surgery, so they can make an informed decision.

FAQs

  1. What are the benefits of combining laparoscopic total and/or supracervical hysterectomy (LTH/LSCH) with laparoscopic sacrocolpopexy (LSC) in treating pelvic organ prolapse?
  2. Are there any significant differences in complications or post-surgery issues between LTH/LSCH with LSC and minimally invasive sacrohysteropexy (LSH)?
  3. What is the impact of mesh use in surgeries involving a hysterectomy?

Doctor’s Tip

One helpful tip a doctor might tell a patient about laparoscopic hysterectomy is to follow all pre-operative instructions provided by the medical team, such as fasting before the surgery and stopping certain medications. Additionally, it is important to discuss any concerns or questions with the doctor before the procedure to ensure a successful outcome. After the surgery, following post-operative care instructions, such as taking prescribed medications, attending follow-up appointments, and avoiding heavy lifting or strenuous activities, can help with a smooth recovery process.

Suitable For

Overall, patients who are typically recommended for laparoscopic hysterectomy are those with pelvic organ prolapse who are seeking a minimally invasive surgical option that can effectively treat their condition. This may include patients with symptoms such as pelvic pressure, urinary incontinence, and discomfort during sexual intercourse. Additionally, patients who are looking for a shorter recovery time, shorter hospital stay, and better post-operative outcomes may also be good candidates for laparoscopic hysterectomy. It is important for patients to discuss their concerns and treatment options with their healthcare provider to determine the best course of action for their individual situation.

Timeline

Before laparoscopic hysterectomy:

  1. Patient consults with their gynecologist or surgeon about treatment options for pelvic organ prolapse.
  2. Patient undergoes diagnostic tests and evaluations to determine the extent of the prolapse.
  3. Patient discusses the risks and benefits of laparoscopic hysterectomy with their healthcare provider.
  4. Patient schedules the surgery and prepares for it by following pre-operative instructions.

After laparoscopic hysterectomy:

  1. Patient undergoes the minimally invasive laparoscopic hysterectomy procedure.
  2. Patient spends a short recovery period in the hospital before being discharged.
  3. Patient follows post-operative instructions, which may include restrictions on physical activity and medication management.
  4. Patient attends follow-up appointments with their healthcare provider to monitor their recovery and address any concerns.
  5. Patient experiences improved quality of life and relief from symptoms of pelvic organ prolapse after surgery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about laparoscopic hysterectomy include:

  1. What are the specific reasons for recommending a laparoscopic hysterectomy over other treatment options for my condition?
  2. What are the potential risks and complications associated with laparoscopic hysterectomy?
  3. How long is the recovery period after laparoscopic hysterectomy, and what can I expect during this time?
  4. Will I experience any changes in my hormonal balance or menopausal symptoms after the procedure?
  5. What are the chances of needing additional surgeries or treatments in the future after undergoing laparoscopic hysterectomy?
  6. How will my quality of life be impacted after the surgery, including factors such as sexual function and urinary incontinence?
  7. Are there any alternative treatments or procedures that I should consider before deciding on laparoscopic hysterectomy?
  8. Will the use of mesh be involved in the surgery, and if so, what are the potential risks and benefits associated with this approach?
  9. How experienced are you in performing laparoscopic hysterectomies, and what is your success rate with this procedure?
  10. Can you provide me with information about the specific techniques and approaches you will use during the surgery, and how they may affect my recovery and outcome?

Reference

Authors: Tius V, Arcieri M, Taliento C, Pellecchia G, Capobianco G, Simoncini T, Panico G, Caramazza D, Campagna G, Driul L, Scambia G, Ercoli A, Restaino S, Vizzielli G. Journal: Int J Gynaecol Obstet. 2025 Feb;168(2):456-471. doi: 10.1002/ijgo.15891. Epub 2024 Sep 26. PMID: 39324500