Prevalence of Stool Outlet Obstruction After Laparoscopic Sacrocolpopexie

Study Overview
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Brief Summary
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The aim was to evaluate the prevalence of stool outlet obstruction after laparoscopic sacrocolpopexie at the Kantonsspital Aarau in a prospective cross-sectional study. Laparoscopic sacrocolpopexy techniques involving the dissection of the presacral space can compromise fibers of the superior hypogastric plexus. This can contribute to postoperative problems such as incomplete voiding, defecatory dysfunction, pain, and sensory problems. In 2010, the Kantonsspital Aarau has implemented a new nerve-sparing laparoscopic sacrocolpopexy technique. This technique has subjectively reduced the prevalence of stool outlet obstructions but this has not been tested systematically yet. The aim of this study is therefore to compare the patients' subjective conditions between these two surgical techniques using the investigator's standard-of-care German pelvic floor questionnaire.

Detailed Description
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The (pre-) sacral space is characterized by a complex neuroanatomy and surgical intervention in this part of the body is often associated with the dissection of nerve bundels, a procedure which may finally lead to transient defecatory dysfunction. In a earlier study we could show that  17.8% of patient with laparoscopic sacrocolpopexie developed postoperative constipation within 3-6 months. In november 2010 the Frauenklinik Aarau introduced a novel, nerve-sparing technique of laparoscopic sacrocolpopexie. In this study we assess the pre-and postoperative differences in defecatory dysfunction between the two procedures trough the analysis of our standard of care pelvic floor questionnaire.

Official Title
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Prospective Cross-sectional Study on the Prevalence of Stool Outlet Obstruction After Laparoscopic Sacrocolpopexie at the KSA

Conditions
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Stool Outlet Obstruction

Intervention / Treatment
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* Procedure: nerve-sparing laparaoscopic sacrocolpopexy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Women affected by symptomatic vault prolapse, who underwent laparoscopic sacrocolpopexy at the KSA informed consent Exclusion Criteria: participation in other studies Sacrocolpopexie done by Da Vinci Roboter Patients who had a conversion to laparotomy perioperatively Patients with a recurrence who had to undergo a second surgery Patients who had a relaps operation

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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Female

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| non-nerve-sparing laparaoscopic sacrocolpopexy.<br> | |
| nerve-sparing laparaoscopic sacrocolpopexy.<br> | Procedure: nerve-sparing laparaoscopic sacrocolpopexy<br>* nerve-sparing laparaoscopic sacrocolpopexy implemented after 2010<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| the number of de novo or worsened obstructed defecation | comparison of the number of de novo or worsened obstructed defecation of a cohort of patients who underwent nerve-sparing laparaoscopic sacrocolpopexy versus patients who underwent non-nerve-sparing laparaoscopic sacrocolpopexy | 2003-2017 |